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Interactive Cardiovascular and Thoracic Surgery 1:4-8(2002)
© 2002 European Association of Cardio-Thoracic Surgery

Brief communication

Subxiphoid approach for video-assisted thoracoscopic extended thymectomy in treating myasthenia gravis

Chung-Ping Hsua,b,*, Cheng-Yen Chuanga,b, Nan-Yung Hsua,b and Sen-Ei Shiaa,b

a Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
b School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

* Corresponding author. Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, 160, Sec 3, Taichung-Kang Rd., Taichung, Taiwan, ROC. Tel.: +886-4-23592525, ext. 5050; fax: +886-4-23599715
cliff{at}vghtc.vghtc.gov.tw

Previous experience using the transcervical, left or right thoracic approach for thymectomy, although demonstrating promising efficacy, involves some compromise of the surgical exposure. We performed subxiphoid video-assisted thoracoscopic extended thymectomy (SxVATET) on eight consecutive myasthenic patients. The mean operation time, weights of resected specimen, and thoracic drainage period were 156.9 min (range 120–200 min), 77.5 g (range 40–100 g), and 3.4 days (range 3–4 days), respectively. There were no surgical complications or mortalities, and the cosmesis is satisfying. Our experience demonstrates that SxVATET provides an excellent view of the bilateral pleural cavities. Subsequently, extended thymectomy, resecting ample mediastinal fatty tissue in addition to the thymic glands, can be safely undertaken.

Key Words: Thymectomy; Myasthenia gravis; Thoracoscopy; Subxiphoid

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