Video-assisted Thoracoscopic Thymectomy For Myasthenia Gravis

Objective The aim of this study was to examine the thoracoscopic versus open approaches(transsternal) to thymectomy in patients with myasthenia gravis(MG).Methods The data of 16 patients with thymectomy by thoracoscopic approach were analyzed retrospectively and compared to the open group of 23 patients. Then we study the patient selection, operative techniques, perioperative management and results for thoracoscopic approach.Results The thoracoscopic group had a mean operating time of 1.556 hours compared with 1.709 hours in the open group. The thoracoscopic group had a mean estimated blood loss of 116.25ml compared with 299.55ml in the open group. The mean tracheal intubating time postoperatively for the thoracoscopic group was 7.69 hours and was 6.70 hours in the open group. The thoracoscopic group had a mean time of chest draining of 2.56 days compared with 3.22 days in the open group. The mean amount of chest draining postoperatively for the thoracoscopic group was 227.14ml and was 405.22ml in the open group.Conclusions Both thoracoscopic and open approaches to thymectomy in patients with MG are effective. The thoracoscopic group has the added benefits of decreased estimated blood loss, decreased time and amount of chest draining, and improvedcosmesis compared to the open group. The mean operating time and tracheal intubating time are not obviously different between the two groups. We advocate the thoracoscopic approach for thymectomy in the treatment of MG.