[Video-assisted thoracoscopic extended thymectomy for myasthenia gravis]

Lei Yu, Shan Ma, Tian-you Wang, Ju-gao Fang, Yun Jing, Yun-feng Zhang, Nan Zang
Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery] 2008 November 15, 46 (22): 1720-2

OBJECTIVE: To investigate the outcome of video-assisted thoracoscopic extended thymectomy (VATET) for myasthenia gravis.

METHODS: From January 2005 to February 2006, VATET had been performed for 41 patients of myasthenia gravis. Among them, 23 patients were female and 18 were male. The age ranged from 18 to 67 years old, and the disease duration ranged from 1 month to 3 years. In order to achieve maximal benefit, a transverse cervical incision was given access to the peri-thyroid space to remove fat in the neck which may contain ectopic thymus after all thymic tissue, including far-reaching ectopic sites. Peri-thymic adipose tissue in the anterior mediastinum was completely removed.

RESULTS: In the 41 patients, mean operative time was 162 min. Sever patients sustained myasthenic crises that required reintubation and mechanical ventilation for a few days. Of all patients, 35 had lymphadenectasis, and 4 had ectopic thymus in the peri-thyroid space. After the 2 years' follow-up, the rate of complete stable remission was 41.4%, and the effective rate was 85.4%.

CONCLUSIONS: Video-assisted thoracoscopic thymectomy represents a safe and valid approach for patients with myasthenia gravis. VATET may be a complement to completely remove all thymus including ectopic tissues.

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