Video assisted thoracoscopic extended thymectomy (VATET) in Myasthenia Gravis: 101 patients followed-up to 2 years and comparison with transternal approach

Thymectomy without stemotomy was performed by bilateral VATET in 101 MG patients. The histological evaluation revealed a thymoma in 20.89? of cases, an hyperplastic thymus in 48.5% and an involuted thymus in 30.7%. Fifty-seven (56.4%) of our patients had a follow-up of at least 1 year; 30 (29.7%) patients up to 2 years. Comparison of tissue removed by VATET or standard transternal thymectomy showed significant differences in all cases (55.6 ±38.2 vs. 35.54 ±35 grams, p = 0.001) or in only those without thymoma (43.6 ±21.5 vs. 26.3 ±23.5 grams, p = 0.0001) (unpaired r-Test). In the VATET patients the clinical conditions were detected at the end of follow-up: remission, 23.3%; pharmacological remission, 41.7%; ocular, 6.7%: generalized, 23.3%; bulbar, 5% compared to 1.7, 30, 13.3, 45 and 10%, respectively, before thymectomy. No complication occured immediately after or later on in the follow-up. On the basis of these results VATET technique is proposed as a safe, reliable and even more radical thymectomy for MG treatment.