Extended transcervical thymectomy: the ultimate minimally invasive approach.
The ideal operative technique for thymectomy in myasthenia gravis remains controversial. Most surgeons perform thymectomy through median sternotomy; more recently, thoracoscopic and robotic approaches have been described. "Extended transcervical thymectomy" is an out-patient procedure that appears less morbid and costly than other approaches. It allows a complete extracapsular thymic resection. Kaplan-Meier complete stable remission rates after transcervical thymectomy are 33% and 35% at 3 and 6 years (higher including patients remaining on single-drug immunosuppression). The major surgical complication rate is 0.7%. We believe that this less morbid and less costly operation is a very reasonable choice in the surgical treatment of myasthenia gravis.
Shrager
Joseph B
JB
Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California 94305, USA. shrager@stanford.edu
D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009157:Myasthenia Gravis / Q000601:surgery*; D009333:Neck; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy / Q000379:methods*