Video-assisted thoracoscopic thymectomy in juvenile myasthenia gravis

As video-assisted thoracoscopic surgery for thymectomy has been reported to be as effective as traditional open surgical approaches in predominantly a dult patients with myasthenia gravis, we applied this procedure to juvenile patients with this condition. Six patients underwent total thymectomy usin g the video-assisted technique (1997-98). Six patients in whom a median tra nssternal approach was used (1989-95) formed the comparison group. The two patient groups were similar in terms of age at thymectomy and preoperative clinical severity. There were no serious perioperative complications in eit her group. Minimum post-thymectomy duration of follow-up in the video-assis ted thoracoscopic surgery patients was 2.3 years (mean 2.7 years), with all patients clinically improved over their baseline status. Preliminary resul ts suggest that video-assisted thymectomies are comparably effective to tra nssternal procedures in treating generalized juvenile myasthenia gravis and can be safely performed in children as young as 20 months of age. In addit ion, video-assisted surgeries are less invasive than transsternal approache s, significantly shorten the postoperative hospital stay, and have superior cosmetic results.