Thymectomy is an effective, but radical therapy for myasthenia. Traditionally, thymectomy for myasthenia gravis has been performed using either a transcervical approach or a median sternotomy. The excision of the thymic tissue by video-assisted thoracoscopic (VATS) surgery is less aggressive and recovery is faster. The aim of this study was to evaluate the usefulness and outcomes of VATS thymectomy for myasthenia gravis in a unit specializing in advanced VATS techniques.
Over the past 2 years, we have performed 41 video-assisted thoracoscopic thymectomies on patients with myasthenia gravis at our unit. This study included 29 women and 12 men, with a mean age of 36.6 years (range, 18-55 years). Only left-side thoracoscopic surgery was performed, with a mean intervention time of 99 minutes (range, 72-122 minutes).
There was no perioperative mortality and all procedures were concluded successfully, with one patient requiring sternotomy in case of intraoperative bleeding. No patient required assisted ventilation postoperative and the maximum stay in intensive care was less than 24 hours. Postoperative there was no necessity for any surgical intervention. Mean time of hospital stay was 6.2 days (range, 5 -9). The clinical outcome was excellent in 25 cases (medical treatment no longer required), good in 10 (reduced medical treatment), and poor in 6 (no changes).
Video-assisted thoracoscopic thymectomy is effective in the treatment of myasthenia gravis and improves patient recovery. In addition, the excellent surgical view allows the thymectomy to be performed with absolute safety.
We recommend VATS-thymectomy in every case of myasthenia gravis without thymoma or paraneoplastic myasthenia.
Erich Hecker, None.