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.