title: [Thymectomy for myasthenia gravis by video-assisted thoracoscopic surgery through right anterior-lateral approach].
abstract: OBJECTIVE
  To evaluate the feasibility and curative effect of thymectomy for myasthenia gravis (MG) by video-assisted thoracoscopic surgery (VATS) through right anterior-lateral approach.
  
  
  METHODS
  Fifty-six patients of MG were treated with thoracoscopic thymectomy and mediastinal fat dissection through right anterior-lateral approach from August 2001 to October 2007. The feasibility, safety, complication and remission for MG were retrospectively analyzed.
  
  
  RESULTS
  Fifty-five operations were completed by VATS. The mean operative time and blood loss were (96.2 +/- 52.1) min and (68.7 +/- 21.4) ml, respectively. The brachiocephalic vein injury by the electric coagulator occurred in two cases and one of them performed thoracotomy for homeostasis, the other performed ligation. The postoperative pathology showed hyperplasia in 38 cases, atrophy in 5 cases, thymoma in 12 cases and cyst of thymus in 1 case. And the operative complication included one myasthenia crisis (1.8%) at the third day and one death (1.8%) at the eighth day because of postoperative hemorrhage. The average length of stay was (7.9 +/- 2.9) d. All cases were followed up from one to seventy months. Eight (14.3%) of complete remission, 39 cases (69.6%) of partial remission and 7 cases (12.5%) of no change were found. The total effective rate was 83.9%.
  
  
  CONCLUSIONS
  Thoracoscopic thymectomy through right anterior lateral approach is technically feasible, safe and minimally invasive. It has a high remission rate for MG.
authors.affiliation: Department of Thoracic Surgery, Daping Hospital & Research Institute of Surgery, the Third Military Medical University, Chongqing 400042, China.
authors.forename: Qun-you
authors.initials: QY
authors.lastname: Tan
authors.forename: Ru-wen
authors.initials: RW
authors.lastname: Wang
authors.forename: Yao-guang
authors.initials: YG
authors.lastname: Jiang
authors.forename: Bo
authors.initials: B
authors.lastname: Deng
authors.forename: Zheng
authors.initials: Z
authors.lastname: Ma
authors.forename: Tai-qian
authors.initials: TQ
authors.lastname: Gong
authors.forename: Jing-hai
authors.initials: JH
authors.lastname: Zhou
authors.forename: Yun-ping
authors.initials: YP
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000601:surgery*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy / Q000379:methods*; D016896:Treatment Outcome