Background: Although transsternal thymectomy is an effective method in the
treatment of juvenil myasthenia gravis (JMG) it is traumatic in pediatric p
atients. Thoracoscopic thymectomy offers an effective and less traumatic ap
proach with respect to cosmesis and postoperative recovery.
Methods: A retrospective analysis of 6 consecutive patients treated with th
oracoscopic thymectomy was performed, Perioperative parameters and cost ana
lysis were compared with those of 6 consecutive open procedures performed b
efore the study.
Results: Thoracoscopic thymectomy can be performed in patients as young as
1.6 years. There was no conversion to open procedure and no perioperative m
orbidity and mortality. The length of operating time and the surgical cost
of thoracoscopic procedure were not significantly different from those of o
pen procedure. The length of hospitalization, however, was significantly sh
orter with thoracoscopic procedure, and hence the overall cost was signific
antly reduced (P < .05). An intermediate follow-up shows that outcome after
thoracoscopic procedure is equally as effective as open procedure.
Conclusions: Thoracoscopic thymectomy offers an equally effective but cosme
tically more acceptable approach than sternotomy. It has a quicker recovery
period and appears to be a less costly alternative to transsternal thymect
omy. Copyright (C) 2000 by W.B. Saunders Company.