As a part of the multimodal treatment of myasthenia gravis patients, thymectomy is an established method with positive effects in some patients. The traditional surgical approach, sternotomy, was modified over the years from total to partial sternotomy, but despite this offers a suboptimal aesthetic result with a scar in the decolletage region in mostly female patients. At the Jordanovac Department of Thoracic Surgery, a minimally invasive video-assisted method has been performed since 2016 in the treatment of patients with myasthenia gravis who, in collaboration with a neurologist, are estimated to be able to benefit from thymectomy. We present the results of a new method at the Jordanovac Department of Thoracic Surgery in the multimodal treatment of patients with myasthenia gravis. In the first 4 years, we operated on 50 patients with extremely low perioperative complications, short hospitalization time, and low need for postoperative analgesic therapy. In the first year, we operated on 14 patients. Access was generally right-sided through three or four thoracic ports. In case of suspected thymoma, access depended on tumor localization. In the second year, we operated on 8 patients, in the third 9, and in the fourth 19 patients. The thoracic drainage was removed on the 1st post-operative day in all patients. Hospitalization duration was 2–4 days. Video assisted thymectomy is the standard in the treatment of patients with myasthenia gravis and patients with thymoma up to 5 cm in diameter. The outcomes significantly outperform those of a sternotomy and maintain equivalent oncological efficacy.
Djaković et al. (Thu,) studied this question.