{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T19:44:14Z","timestamp":1789328654484,"version":"build-2803163510"},"reference-count":39,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>This single-center retrospective exploratory analysis evaluated the effects of sugammadex compared with neostigmine on postoperative recovery in patients with myasthenia gravis (MG) who underwent video-assisted thoracoscopic surgery (VATS)\u2013thymectomy. This retrospective study included 180 patients with MG, aged &gt;18 years, who received sugammadex (sugammadex group, n = 83) or neostigmine\u2013glycopyrrolate (neostigmine group, n = 88) after VATS\u2013thymectomy between November 2007 and December 2020. Inverse probability of treatment weighting (IPTW) adjustment was performed to balance the baseline characteristics between the two groups. The primary outcome was the length of postoperative hospital stay, and the secondary outcomes were the incidence of postoperative mortality and complications, as well as the postoperative extubation and reintubation rates, in the operating room after VATS\u2013thymectomy; the outcomes were compared between the two groups. After IPTW adjustment, the sugammadex group showed a significantly shorter median postoperative hospital stay than the neostigmine group (4 (2, 4) vs. 5 (3, 6) days, respectively; p = 0.003). There were no significant differences between the two groups in the incidences of postoperative complications (including postoperative myasthenic crisis, nerve palsy, atelectasis, and pleural effusion). Patients with MG following VATS\u2013thymectomy who received sugammadex showed a significantly shorter postoperative hospital stay than those who received neostigmine.<\/jats:p>","DOI":"10.3390\/jpm13091380","type":"journal-article","created":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T06:12:21Z","timestamp":1694931141000},"page":"1380","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison between Sugammadex and Neostigmine after Video-Assisted Thoracoscopic Surgery\u2013Thymectomy in Patients with Myasthenia Gravis: A Single-Center Retrospective Exploratory Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Hyun-Joung","family":"No","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6334-7541","authenticated-orcid":false,"given":"Young Chul","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6258-5695","authenticated-orcid":false,"given":"Young Jun","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6328-6948","authenticated-orcid":false,"given":"Hye Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Research Affairs, Biostatistics Collaboration Unit, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9916-1917","authenticated-orcid":false,"given":"Soyoung","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Research Affairs, Biostatistics Collaboration Unit, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Hong","family":"Kweon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3685-2005","authenticated-orcid":false,"given":"Na Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/aas.12123","article-title":"Rocuronium and sugammadex in patients with myasthenia gravis undergoing thymectomy","volume":"57","author":"Yavru","year":"2013","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1111\/anae.12322","article-title":"A randomised controlled trial comparing the glidescope\u00ae and the macintosh laryngoscope for double-lumen endobronchial intubation","volume":"68","author":"Russell","year":"2013","journal-title":"Anaesthesia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1007\/s12630-022-02230-3","article-title":"Mapping the current evidence on the anesthetic management of adult patients with neuromuscular disorders-a scoping review","volume":"69","author":"Gubbels","year":"2022","journal-title":"Can. J. Anaesth."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-2004-829587","article-title":"Anesthesia issues in the perioperative management of myasthenia gravis","volume":"24","author":"Dillon","year":"2004","journal-title":"Semin. Neurol."},{"key":"ref_5","first-page":"266","article-title":"A novel concept of reversing neuromuscular block: Chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host","volume":"41","author":"Bom","year":"2002","journal-title":"Angew. Chem. Int. Ed. Engl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/00000542-200309000-00018","article-title":"Reversal of neuromuscular blockade and simultaneous increase in plasma rocuronium concentration after the intravenous infusion of the novel reversal agent org 25,969","volume":"99","author":"Epemolu","year":"2003","journal-title":"Anesthesiology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/anae.14160","article-title":"The comparative efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. A cochrane systematic review with meta-analysis and trial sequential analysis","volume":"73","author":"Hristovska","year":"2018","journal-title":"Anaesthesia"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/EJA.0b013e3283392593","article-title":"Successful use of rocuronium and sugammadex in a patient with myasthenia","volume":"27","author":"Petrun","year":"2010","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/j.1365-2044.2009.06236.x","article-title":"The use of sugammadex in a patient with myasthenia gravis","volume":"65","author":"Unterbuchner","year":"2010","journal-title":"Anaesthesia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1111\/j.1365-2044.2010.06360.x","article-title":"Sugammadex in patients with myasthenia gravis","volume":"65","author":"Driessen","year":"2010","journal-title":"Anaesthesia"},{"key":"ref_11","first-page":"476","article-title":"Effective reversal of muscle relaxation by rocuronium using sugammadex in a patient with myasthenia gravis undergoing laparoscopic cholecystectomy","volume":"60","author":"Komasawa","year":"2011","journal-title":"Masui Jpn. J. Anesthesiol."},{"key":"ref_12","first-page":"361","article-title":"Anaesthetic management of a patient with myasthenia gravis for abdominal surgery using sugammadex","volume":"7","author":"Piechota","year":"2011","journal-title":"Arch. Med. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.ijoa.2012.02.006","article-title":"Use of rocuronium and sugammadex for caesarean delivery in a patient with myasthenia gravis","volume":"21","author":"Garcia","year":"2012","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/aas.12391","article-title":"High-dose rocuronium for rapid-sequence induction and reversal with sugammadex in two myasthenic patients","volume":"58","author":"Casarotti","year":"2014","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/EJA.0000000000000153","article-title":"Reversal of neuromuscular blockade with sugammadex in patients with myasthenia gravis: A case series of 21 patients and review of the literature","volume":"31","author":"Shields","year":"2014","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_16","first-page":"491","article-title":"Anesthetic management of aortic valve replacement in a myasthenia gravis patient, the era of a new reversal","volume":"23","author":"Dabbous","year":"2016","journal-title":"Middle East J. Anaesthesiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jclinane.2016.11.008","article-title":"Use of sugammadex in an octagenerian with myaesthenia gravis undergoing emergency laporotomy","volume":"37","author":"Shah","year":"2017","journal-title":"J. Clin. Anesth."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.2147\/TCRM.S93009","article-title":"Feasibility of full and rapid neuromuscular blockade recovery with sugammadex in myasthenia gravis patients undergoing surgery\u2014A series of 117 cases","volume":"11","author":"Vymazal","year":"2015","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1213\/ANE.0000000000004239","article-title":"Effect of sugammadex on postoperative myasthenic crisis in myasthenia gravis patients: Propensity score analysis of a japanese nationwide database","volume":"130","author":"Mouri","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1097\/EJA.0000000000001500","article-title":"Rocuronium reversed with sugammadex for thymectomy in myasthenia gravis: A retrospective analysis of complications from japan","volume":"38","author":"Tsukada","year":"2021","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kim, N., Lee, S.H., Choi, K.W., Lee, H., and Oh, Y.J. (2019). Effects of positive end-expiratory pressure on pulmonary oxygenation and biventricular function during one-lung ventilation: A randomized crossover study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050740"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Lee, K., Oh, Y.J., Kim, M., Song, S.H., and Kim, N. (2022). Effects of iloprost on oxygenation during one-lung ventilation in patients with low diffusing capacity for carbon monoxide: A randomized controlled study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11061542"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1111\/j.1399-6576.2007.01352.x","article-title":"Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents ii: The stockholm revision","volume":"51","author":"Claudius","year":"2007","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e76","DOI":"10.1093\/ejcts\/ezt641","article-title":"Thymectomy in myasthenia gravis: Proposal for a predictive score of postoperative myasthenic crisis","volume":"45","author":"Leuzzi","year":"2014","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1093\/ejcts\/ezx163","article-title":"Risk factors of myasthenic crisis after thymectomy for thymoma patients with myasthenia gravis","volume":"52","author":"Xue","year":"2017","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/j.1524-4733.2009.00671.x","article-title":"Use of stabilized inverse propensity scores as weights to directly estimate relative risk and its confidence intervals","volume":"13","author":"Xu","year":"2010","journal-title":"Value Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3661","DOI":"10.1002\/sim.6607","article-title":"Moving towards best practice when using inverse probability of treatment weighting (iptw) using the propensity score to estimate causal treatment effects in observational studies","volume":"34","author":"Austin","year":"2015","journal-title":"Stat. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1093\/biomet\/ast027","article-title":"Two-sample rank tests under complex sampling","volume":"100","author":"Lumley","year":"2013","journal-title":"Biometrika"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s10557-022-07319-x","article-title":"Comparison of sodium-glucose cotransporter-2 inhibitor and dipeptidyl peptidase-4 inhibitor on the risks of new-onset atrial fibrillation, stroke and mortality in diabetic patients: A propensity score-matched study in hong kong","volume":"37","author":"Lee","year":"2023","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1089\/lap.2021.0417","article-title":"Clinical outcomes between a minimally invasive and open extended cholecystectomy for t2 gallbladder cancer: A propensity score matching analysis","volume":"32","author":"Lee","year":"2022","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1399-6576.2011.02558.x","article-title":"Anesthesia and myasthenia gravis","volume":"56","author":"Hansen","year":"2012","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/ACO.0000000000000466","article-title":"Anesthetic consideration for neuromuscular diseases","volume":"30","author":"Katz","year":"2017","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_33","first-page":"28","article-title":"Neuromuscular block reversal with sugammadex in a morbidly obese patient with myasthenia gravis","volume":"44","author":"Jakubiak","year":"2012","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1093\/bja\/aet098","article-title":"Fade of train-of-four ratio despite administration of more than 12 mg kg\u22121 sugammadex in a myasthenia gravis patient receiving rocuronium","volume":"110","author":"Kiss","year":"2013","journal-title":"Br. J. Anaesth."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/ACC.0b013e3182953053","article-title":"Restoration of train-of-four ratio with neostigmine after insufficient recovery with sugammadex in a patient with myasthenia gravis","volume":"1","author":"Sugi","year":"2013","journal-title":"A&A Case Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"43","DOI":"10.15280\/jlm.2016.6.1.43","article-title":"Rapid return of spontaneous respiration after general anesthesia with sugammadex in a patient with myasthenia gravis","volume":"6","author":"Kim","year":"2016","journal-title":"J. Lifestyle Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Fernandes, H.D.S., Ximenes, J.L.S., Nunes, D.I., Ashmawi, H.A., and Vieira, J.E. (2019). Failure of reversion of neuromuscular block with sugammadex in patient with myasthenia gravis: Case report and brief review of literature. BMC Anesthesiol., 19.","DOI":"10.1186\/s12871-019-0829-0"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.21037\/jtd.2019.03.51","article-title":"Saving the split: The benefits of vats thymectomy","volume":"11","author":"Gross","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1056\/NEJMra1602678","article-title":"Myasthenia gravis","volume":"375","author":"Gilhus","year":"2016","journal-title":"N. Engl. J. Med."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/9\/1380\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:51:36Z","timestamp":1760129496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/9\/1380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,15]]},"references-count":39,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jpm13091380"],"URL":"https:\/\/doi.org\/10.3390\/jpm13091380","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,15]]}}}