Association Between Pleural Breach and Perioperative and Long-Term Outcomes after Thymectomy for Myasthenia Gravis: A Two-Center Retrospective Study

OBJECTIVE: Thymectomy is an established treatment for myasthenia gravis and thymic tumors. This study evaluated the impact of pleural breach on perioperative pleural-related morbidity and long-term neurologic and oncologic outcomes following thymectomy. MATERIAL AND METHODS: A retrospective multicenter review of 455 patients who underwent thymectomy between January 2005 and December 2024 was conducted at Services Hospital and Surgimed Hospital, Lahore, Pakistan. Patients underwent either a partial transsternal thymectomy (n = 273) or a video-assisted thoracoscopic surgery (VATS) thymectomy (n = 182). The primary outcome was pleural-related postoperative morbidity. Secondary outcomes included neurologic remission, recurrence-free survival (RFS), postoperative complications, and hospital stay. RESULTS: = 0.538, respectively). CONCLUSION: Pleural breach during thymectomy was independently associated with increased transient pleural-related postoperative morbidity (OR: 2.6). However, these complications were generally self-limited and managed conservatively. Long-term neurologic remission and RFS were comparable between surgical approaches, but these findings should be interpreted cautiously given the retrospective observational design.