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Ann Thorac Surg 2006;82:1003-1007
© 2006 The Society of Thoracic Surgeons

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Original article: General thoracic

Thoracoscopic Thymectomy Mid-Term Results

^a Department of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
^b Department of Neurology, Fundeni Clinical Institute, Bucharest, Romania
^c Department of Health Psychology and Psychosomatics, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania

Accepted for publication April 27, 2006.

^_* Address correspondence to Dr Popescu, Department of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Sos. Fundeni 253, Sector 2, 72434 Bucharest, Romania. (Email: irinel.popescu{at}icfundeni.ro).

BACKGROUND: Results of thymectomy in patients with myasthenia gravis need to be reported in a standardized way to allow accurate comparison.

METHODS: A retrospective study was conducted of 107 patients with myasthenia gravis without thymoma. Patients were followed-up for more than 12 months after thoracoscopic thymectomy and analyzed according to Myasthenia Gravis Foundation of America Recommendations for Clinical Research Standards.

RESULTS: The study population was aged 8 to 60 years old and included 15 men (14%) and 92 women (86%). A right-side approach was used in 36 patients, and the remaining 71 patients had a left-side approach. Mortality was 0% and morbidity was 9.34%. The mean operative time was 90 ± 45 minutes. The histologic diagnosis of the resected thymus was hyperplasia (78.5%), atrophy (15%), and normal status (6.5%). The mean length of hospitalization was 2.3 days (range, 2 to 6 days). The mean follow-up was 36.4 months (range, 12 to 74 months). The rate of complete stable remission was 59.5% by the end of postoperative year 6. An earlier onset age and early operation were significantly associated with complete stable remission and pharmacologic remission. A comparison of right side versus left side approach showed similarities in mean operative time, mean length of hospitalization, histopathologic results, and remission rates.

CONCLUSIONS: Outcomes of the thoracoscopic approach in myasthenia gravis without thymoma were similar to those provided by open surgery, with the acknowledged benefits of minimally invasive surgery and good patient acceptance.

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