{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T13:42:00Z","timestamp":1782135720765,"version":"3.54.5"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Complete thymectomy is a key component of the optimal treatment for myasthenia gravis. Unilateral, minimally invasive approaches are increasingly utilized with debate about the optimal laterality approach. A right-sided approach has a wider field of view, while a left-sided approach accesses potentially more thymic tissue. We aimed to assess the impact of laterality on perioperative and medium-term outcomes, and to identify predictors of a \u2018good outcome\u2019 using standard definitions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We performed a multicentre review of 123 patients who underwent a minimally invasive thymectomy for myasthenia gravis between January 2000 and August 2015, with at least 1-year follow-up. The Myasthenia Gravis Foundation of America standards were followed. A \u2018good outcome\u2019 was defined by complete stable remission\/pharmacological remission\/minimal manifestations 0, and a \u2018poor outcome\u2019 by minimal manifestations 1\u20133. Univariate and multivariable logistic regression analyses were performed to assess factors associated with a \u2018good outcome\u2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Ninety-two percent of thymectomies (113\/123) were robotic-assisted. The left-sided approach had a shorter median operating time than a right-sided: 143 (interquartile range, IQR 110\u2013196) vs 184 (IQR 133\u2013228) min, P\u2009=\u20090.012. At a median of 44 (IQR 27\u201375) months, the left-sided approach achieved a \u2018good outcome\u2019 (46%, 31\/68) more frequently than the right-sided (22%, 12\/55); P\u2009=\u20090.011. Multivariable analysis identified a left-sided approach and Myasthenia Gravis Foundation of America class I\/II to be associated with a \u2018good outcome\u2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A left-sided thymectomy may be preferred over a right-sided approach in patients with myasthenia gravis given the shorter operating times and potential for superior medium-term symptomatic outcomes. A lower severity class is also associated with a \u2018good outcome\u2019.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab014","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T00:41:57Z","timestamp":1610239317000},"page":"898-905","source":"Crossref","is-referenced-by-count":22,"title":["Minimally invasive thymectomy for myasthenia gravis favours left-sided approach and low severity class"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3637-1802","authenticated-orcid":false,"given":"Candice L","family":"Wilshire","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Swedish Cancer Institute, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra L","family":"Blitz","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Swedish Cancer Institute, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3767-8352","authenticated-orcid":false,"given":"Carson C","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Swedish Cancer Institute, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens C","family":"R\u00fcckert","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3768-3816","authenticated-orcid":false,"given":"Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5598-599X","authenticated-orcid":false,"given":"Robert J","family":"Cerfolio","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asem F","family":"Ghanim","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W","family":"Onaitis","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of California San Diego, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inderpal S","family":"Sarkaria","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis A","family":"Wigle","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-1545","authenticated-orcid":false,"given":"Scott","family":"Reznik","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5855-7245","authenticated-orcid":false,"given":"Adam 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