Thoracoscopic thymectomy in autoimmune myasthesia: results of left-sided approach.
BACKGROUND
We undertook to analyze the results of video-assisted thoracoscopic thymectomy through a left-sided approach in patients with autoimmune myasthenia.


METHODS
Between 1993 and 1997, 31 patients underwent thoracoscopic thymectomy by a uniform left-sided approach. There were 8 men and 23 women with a mean age of 34 +/- 12 years.


RESULTS
Preoperative duration of disease was 14.8 +/- 11 months. There were no operative deaths or major complications. The mean hospital stay was 5.2 +/- 2.8 days. Mean follow-up was 39.6 +/- 15 months and was 100% complete. At 48 months, remission and improvement rates were 36% and 96%, respectively. Shorter duration of symptoms (< 12 months) correlated with improved outcome (13 of 13 patients versus 10 of 14 patients; p = 0.036). Age, sex, Osserman class, corticosteroid therapy, presence of ectopic thymic tissue, and temporary postoperative symptom increase (deterioration) did not affect outcome.


CONCLUSIONS
Thoracoscopic thymectomy facilitated the goal of early thymectomy. Through a left-sided approach, improvement or remission was achieved in more than 95% of the patients. Thoracoscopic thymectomy should be considered a valid less invasive alternative to the most radical open approaches.
Mineo
T C
TC
Department of Thoracic Surgery, Tor Vergata University, Rome, Italy. mineo@med.uniroma2.it
Pompeo
E
E
Lerut
T E
TE
Bernardi
G
G
Coosemans
W
W
Nofroni
I
I
D000328:Adult; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D009157:Myasthenia Gravis / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy; D013934:Thymectomy / Q000379:methods*; D016896:Treatment Outcome