Original articles: General thoracicThoracoscopic thymectomy in autoimmune myasthenia: results of left-sided approach
Section snippets
Material and methods
Between January 1993 and December 1997, 31 patients (8 men and 23 women) with autoimmune myasthenia (AM) underwent VATS thymectomy at two participating institutions (Tor Vergata University in Rome, Italy, and Catholic University in Leuven, Belgium). The thoracic surgeons at each institution had gained experience with various major thoracoscopic procedures before embarking on the study. Informed consent was obtained from all patients, who were given the basic information on the different
Results
Patient age ranged from 20 to 69 years with a mean of 34 ± 12 years. The preoperative mean Osserman class was 2.16 ± 0.7; 6 patients were in class 1, 13 in class 2, 10 in class 3, and 2 in class 4. The duration of symptoms ranged from 1 month to 46 months with a mean of 14.8 ± 11 months. Preoperatively, pyridostigmine bromide alone was used in 23 patients (74%), and corticosteroids were used in 8 patients (26%), either alone (1 patient) or in association with pyridostigmine (7 patients).
Comment
Video-assisted thoracoscopic surgery has provided a new approach for the surgical removal of the thymus. Proponents of VATS thymectomy believe that it combines the minimal surgical trauma of the transcervical approach and the excellent visualization of the anterior mediastinum of the transsternal approach. Also, VATS does not prevent easy access to the lower cervical area, thereby allowing complete removal of the superior thymic horns 8, 9, 10, 11. Recognized advantages of VATS over open
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