Abstract: Objective To investigate the value of videoassisted thoracoscopic surgery (VATS) in the treatment of myasthenia gravis (MG) by comparing the early clinical outcomes of extensive thymectomy of VATS and median sternotomy. Methods 195 patients who received extended thymectomy for MG from July 1998 to May 2007 in our department were divided into two groups by operative approach, 83 patients in the VATS group (from April 2002 to May 2007) and 112 patients in the full median sternotomy group(from July 1998 to May 2007). The clinical features, such as operative time, operative blood loss, postoperative drainage, the incidence of crisis, duration of crisis (time of mechanical ventilation), were retrospectively analysed by independent samples t test or chisquare test to evaluate the early outcomes.Results The postoperative drainage in the VATS group was more than that in the median sternotomy group (164.65±38.19ml vs. 98.26±26.84ml, P=0.023), and the operative blood loss in the VATS group was less than that in the median sternotomy group（53.24±11.69ml vs. 97.37±24.61ml,P=0.036）. The incidence of crisis in the VATS group was 4.82%（4/83），which was less than that in the median sternotymy group ［13.39%(15/112), P=0.046,OR=3.054］. And the persistence time of mechanical ventilation for post-operative crisis in the VATS group was much shorter than that in median sternotomy group （75.33±39.31h vs. 189.20±89.74h, P=0.012）. Conclusion VATS extended thymectomy for myasthenia gravis is safe and less invasive. It can decrease the incidence of crisis and the time of mechanical ventilation of crisis, as well as decreasing operative blood loss.
Citation： GAO Ke,CHEN Lunyuan,LIU Dan,LIU Lunxu,WU Zhu,KOU Yingli,CHE Guowei,WANG Yun.. Comparison of the Early Outcomes of Extended Thymectomy for Myasthenia Gravis Between Video-assisted Thoracoscopic Surgery and Median Sternotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2008, 15(2): 92-95. doi: Copy