Thymectomy by thoracoscopic approach in myasthenia gravis

Surg Endosc. 2002 Apr;16(4):679-84. doi: 10.1007/s00464-001-9114-6. Epub 2001 Dec 31.

Abstract

Background: A series of 25 thoracoscopic thymectomies performed in the Department of General Surgery and Liver Transplantation of the Fundeni Clinical Institute between April 1999 and April 2000 is analyzed.

Methods: Thoroscopic thymectomies were performed on 4 male patients (16%) and 21 female patients (84%), aged between 8 and 60 years.

Results: The mean operative time was 90 (+/-15) min. There were no conversions to open thymectomy. Mortality was nil, and morbidity consisted of one minor postoperative right pneumothorax probably related to a injury to right mediastinal pleura that was not observed intraoperatively. Hospital stay ranged from 2 to 4 days, with a mean of 2.28 days. The patients were transferred to the neurological department and they were usually discharged after 1 more day.

Conclusions: Postoperatively, all patients had clinical improvement of their disease both in symptoms and medication requirements, but a longer follow-up is necessary. The results are edifying regarding the very low morbidity, the lack of mortality, the acceptance of the patients, and the short hospitalization.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Child
  • Cholinesterase Inhibitors / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Length of Stay
  • Male
  • Middle Aged
  • Myasthenia Gravis / drug therapy
  • Myasthenia Gravis / mortality
  • Myasthenia Gravis / surgery*
  • Pneumothorax / etiology
  • Postoperative Complications / etiology
  • Prednisone / therapeutic use
  • Preoperative Care / methods
  • Thoracoscopy / methods*
  • Thoracoscopy / mortality
  • Thymectomy / methods*
  • Thymectomy / mortality
  • Time Factors

Substances

  • Anti-Inflammatory Agents
  • Cholinesterase Inhibitors
  • Immunosuppressive Agents
  • Prednisone