Thoracoscopic thymectomy in juvenile myasthenia gravis

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.