title: Comparison of outcomes after extended thymectomy for myasthenia gravis: bilateral thoracoscopic approach versus sternotomy.
abstract: Minimally invasive thymectomy procedures have been proposed for nonthymomatous myasthenia gravis. However, few reports stressed that the lower invasiveness or cosmetic benefits also evaluated the rationale of a thymectomy, which is performed to remove as much thymic tissue as possible. We retrospectively reviewed 30 consecutive patients who underwent a bilateral video-assisted thoracoscopic extended thymectomy (VATET) and compared the results with those of 26 patients who underwent a transsternal extended thymectomy (TSET) to determine the amount of removed thymic tissue and clinical prognosis. The amount of blood loss during the operation for VATET (median 60 mL; range nearly 0 to 940 mL) was significantly lower as compared with that of TSET. The median weight of removed thymic tissue (37.0 g; 18.3 to 100.0 g) and remission rates (1 y: 12.5%; 3 y: 30.8%; 4 y: 44.4%) of VATET were comparable with those of TSET. The VATET group had a similar amount of thymo-fatty tissue removed and feasible clinical outcomes as compared with the TSET group, indicating that VATET provides a proper balance between less invasiveness and radical capability.
authors.affiliation: General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita-City, Osaka, Japan. hshiono@nara.med.kindai.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shiono
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kadota
authors.forename: Akio
authors.initials: A
authors.lastname: Hayashi
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D056346:Sternotomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods*; D013934:Thymectomy / Q000379:methods*; D013950:Thymus Gland / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult