Bilateral video-assisted thoracoscopic thymectomy has a surgical extent similar to that of transsternal extended thymectomy with more favorable early surgical outcomes for myasthenia gravis patients.
BACKGROUND
This study aimed to introduce the authors' surgical technique of bilateral video-assisted thoracoscopic thymectomy (BVT) and to compare their early surgical results between BVT and transsternal extended thymectomy (T3-b thymectomy) for patients with myasthenia gravis (MG).


METHODS
The records of 114 patients who underwent either BVT (n = 55) or T3-b thymectomy (n = 59) for MG were reviewed retrospectively between January 2006 and November 2009.


RESULTS
No surgical mortality or major morbidity occurred in either group. There was no conversion to open thymectomy, and no statistical difference was found in operation time between the two groups (112.2 ± 26.2 min for BVT vs. 130.7 ± 27.3 min for T-3b; p = 0.908). The duration of the chest tube, the length of the intensive care unit (ICU) or hospital stay, and the duration of opioid use for pain control were shorter in BVT group. The estimated blood loss and the total amount of drainage were greater in the T3-b thymectomy group. The specimen weights retrieved by BVT (72.5 ± 61.6 g) were similar to those retrieved by T3-b thymectomy (74.1 ± 38.2 g, p = 0.63) in nonthymomatous MG.


CONCLUSIONS
The BVT was a safe procedure with a surgical extent and amount similar to those of T-3b thymectomy and less invasive for patients with MG. Long-term follow-up assessment and more extensive data are mandatory to verify the early surgical outcomes.
Lee
Chang Young
CY
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
Kim
Dae Joon
DJ
Lee
Jin Gu
JG
Park
In Kyu
IK
Bae
Mi Kyung
MK
Chung
Kyung Young
KY
D000328:Adult; D001284:Atrophy; D015505:Chest Tubes; D004954:Esthetics; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000209:etiology / Q000601:surgery*; D009294:Narcotics / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013934:Thymectomy / Q000379:methods*; D013945:Thymoma / Q000150:complications / Q000601:surgery*; D013950:Thymus Gland / Q000473:pathology / Q000601:surgery; D013953:Thymus Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D009294:Narcotics