{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:00:45Z","timestamp":1788782445456,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The safety and feasibility of robotic\u2010assisted (RATS) thymectomy for myasthenia gravis (MG) with onset age\u2009\u2265\u200950\u2009years remain unverified, particularly in very late\u2010onset MG (V\u2010LOMG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were classified into late\u2010onset MG (LOMG, 50\u201364) and very late\u2010onset MG (V\u2010LOMG\u2009\u2265\u200965) based on age of onset. Composite neurological remission (CNR) included complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestations\u20100 (MM\u20100), while favorable outcomes comprised CNR and MM1\u20103.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1041 patients, 172 with MG onset at\u2009\u2265\u200950\u2009years who underwent RATS extended thymectomy were included in the final analysis. The LOMG group comprised 104 patients (45.2% male), while the V\u2010LOMG group included 68 patients (60.3% male). V\u2010LOMG patients had more preoperative MG crises, shorter onset\u2010to\u2010thymectomy intervals, heavier thymic specimens, and less hyperplasia. In ocular\u2010onset MG, generalization was more frequent in LOMG than in V\u2010LOMG. No significant differences were found in other baseline characteristics, perioperative parameters, postoperative complications, and adverse composite outcomes. At a 5.1\u2010year mean follow\u2010up, the V\u2010LOMG group had slightly higher CSR (7.4% vs. 6.7%), CNR (16.2% vs. 11.5%), and favorable outcome rates (52.9% vs. 45.2%) than the LOMG group, with no statistical significance. Both groups, especially V\u2010LOMG (16.0\u2009mg vs. 2.1\u2009mg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), showed a significant corticosteroid dose reduction at the last follow\u2010up, confirming the steroid\u2010sparing effect of thymectomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RATS extended thymectomy appears to be a safe and feasible treatment for patients with MG of onset at age\u2009\u2265\u200950\u2009years, including those with V\u2010LOMG, demonstrating a significant steroid\u2010sparing effect while maintaining favorable neurological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70388","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T11:11:28Z","timestamp":1762341088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Robotic Extended Thymectomy in Late\u2010Onset Myasthenia Gravis: A 21\u2010Year Retrospective Cohort Study of 172 Patients"],"prefix":"10.1111","volume":"32","author":[{"given":"Luyu","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Surgery, Competence Center of Thoracic Surgery Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Department of Thoracic Surgery Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery The First 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