title: Results of videothoracoscopic thymectomy in children: an analysis of 40 patients†.
abstract: OBJECTIVE
  Experience in video-assisted thoracoscopic (VATS) thymectomy is limited in paediatric patients with non-thymomatous myasthenia gravis (MG). The aim of this study is to evaluate the medical status and surgical results of paediatric patients who underwent a VATS thymectomy.
  
  
  METHODS
  Of the 367 VATS thymectomies performed for MG patients in our Department of Thoracic Surgery between June 2002 and April 2013, 40 patients were in the paediatric age group. The data were evaluated retrospectively. Age, sex, duration of disease, body mass index, prescribed medication, duration of the operation, complications, chest tube duration, length of postoperative hospital stay and pain score using a visual analogue scale were analysed.
  
  
  RESULTS
  The average age was 14.8 ± 2.2 years (range, 8-18 years), and 27 (68%) patients were female. The electromyography and acetylcholine receptor antibody tests were positive in 30 (75%) and 27 (67%) patients, respectively. The mean quantitative MG score was 11.5 ± 5.3. The mean prescribed preoperative pyridostigmine bromide dosage was 209 ± 112 mg. Eleven (27.5%) patients were on corticosteroid treatment and 22 (55%) received intravenous immunoglobulin treatment preoperatively. There were no open conversions or mortalities. The average duration of the operation was 48.9 ± 31.3 min. All patients were extubated on the table and only one (2.5%) required mechanic ventilation for 18 h postoperatively. Three (7.5%) patients experienced complications. The average duration of chest drainage and postoperative stay were 20.5 ± 12.1 h and 1.8 ± 1.0 days, respectively. The average pain score using a visual analogue scale was 2.3 ± 1.2.
  
  
  CONCLUSIONS
  A right-sided VATS thymectomy is a safe procedure in paediatric patients with MG.
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey berkerozkan@yahoo.com.
authors.forename: Berker
authors.initials: B
authors.lastname: Özkan
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Adalet
authors.initials: A
authors.lastname: Demir
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kapdagli
authors.affiliation: Department of Anaesthesiology, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Zerrin
authors.initials: Z
authors.lastname: Sungur
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Duman
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Berk
authors.initials: B
authors.lastname: Cimenoglu
authors.affiliation: Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Toker
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D009157:Myasthenia Gravis / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013934:Thymectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Myasthenia gravis; Paediatric thoracoscopy; Thymectomy