[Thymectomy in myasthenia gravis: video-assisted procedures].
OBJECTIVE
We describe the technique, the benefits and the drawbacks of an original video-assisted thymectomy (VAT), performed through an inframammary cosmetic incision and median sternotomy in myasthenia gravis (MG) patients. This procedure is clinically valuable and cosmetically satisfactory so as to be very well accepted by patients, especially by young women. Minimal-access thymectomy has become increasingly popular as surgical treatment for patients with nonthymomatous myasthenia gravis because of its comparable efficacy, safety, and lesser degree of tissue trauma with conventional open surgery.


METHODS
We report a review/interview of 180 MG patients treated between 1993 and 2005. According to Myasthenia Gravis Foundation of America (MGFA), complete stable remission (CSR) and pharmacologic remission (PR) were calculated at the end of a minimal period of 12 months.


RESULTS
A clinical remission was obtained in 41.1% (CR 27.8%, PR 13.3%), who had been followed for at least 12 months from surgery. 95% of these patients judged their cosmetic results to be excellent or good.


CONCLUSIONS
Thymectomy in MG video-assisted infra-mammary cosmetic incision has shown to be a useful surgical approach as demonstrated by the good functional and very good aesthetic results, associated with a very low morbidity and no mortality.
Tessitore
Adele
A
Unità Operativa di Chirurgia Toracica, Policlinico Universitario A. Gemelli, Roma. adeletessi@tiscali.it
Vita
Maria Letizia
ML
Cusumano
Giacomo
G
Congedo
Maria Teresa
MT
Filotico
Mariella
M
Meacci
Elisa
E
Porziella
Venanzio
V
Margaritora
Stefano
S
Granone
Pierluigi
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy / Q000379:methods*