Comparison of the effects of thoracotomy and laparoscopic thymectomy on immune function and inflammatory factors in patients with myasthenia gravis

Abstract

Objective To compare the effect of laparoscopic thymectomy on immune function and inflammatory factors in patients with myasthenia gravis. Methods 80 patients with myasthenia gravis treated by thymectomy were selected, and they were divided into observation group and control group according to the random number method, each group in 40cases. The observation group was treated with video assisted thoracoscopic surgery, the control group was treated by thoracotomy. All the patients were followed up for outpatient visits in 3 months. The incidences of myasthenia gravis crisis in the two groups were compared and the ratio postoperative humoral immunoglobulin levels and inflammation related factor changes were observed. Results The operation time of the observation group [(118.6±11.3)min] was shorter than (138.5±13.8)min of the control group (t=7.056, P<0.05). The amount of bleeding of the observation group [(96.6±3.8)mL] was less than (125.5±5.6)mL of the control group (t=27.008, P<0.05). The hospitalization time of the observation group [(7.2±0.3)d] was shorter than (10.8±1.1)d of the control group (t=19.969, P<0.05). The incidence rate of myasthenia gravis crisis in the observation group was significantly lower than that in the control group (1 patient vs 9 cases, χ2=5.600, P=0.018). The levels of IgM, IgG and IgA in the observation group were (1.65±0.03)mg/L, (9.55±0.12)mg/L, (3.99±0.20)mg/L respectively, which were higher than (1.31±0.02)mg/L, (8.82±0.10)mg/L, (1.81±0.13)mg/L in the control group(t=59.640, 29.557, 57.800, all P<0.05). The IL-6, TNF-α, IL-1, hs-CRP levels in the observation group were (34.5±6.1)ng/mL, (12±0.2)ng/mL, (0.60±0.1)g/mL, (10.3±1.0)mg/L respectively, which were lower than (153±14.1)ng/mL, (18.1±0.5)ng/mL, (0.92±0.2)g/mL, (31.3±2.0)mg/L in the control group (t=48.784, 71.641, 9.051, 59.397, all P<0.05). Conclusion Laparoscopic thymectomy for myasthenia gravis has short operative time and less bleeding. It has little effect on the humoral immune function of the patients and can significantly reduce the inflammatory response and promote the recovery of the patients. Key words: Thoracoscopy; Thymectomy; Myasthenia gravis; Immune function; Inflammatory factors