[Comparative assessment of the effectiveness of traditional and videothoracoscopic thymectomies in complex treatment of myasthenic thymomas].

A retrospective matched-pair comparison was undertaken to evaluate the surgical and neurological outcomes after open and VATS thymectomy for patients with myasthenia gravis (MG) and thymoma. Ten women and seven men aged 14-77 years were operated upon in St. Petersburg Center of intensive pulmanology and thoracic surgery during the years 1995-2002. Results of two groups were compared: 1 - operated by VATS (9 patients) and 2 - operated via sterno- or thoracotomy (8 patients). The first step evaluated the distribution of age, gender, myasthenia severity, size, type of thymoma and Masaoka's stage. No difference between the groups was found. At the same time, the length of chest tube, blood loss, severity of postoperative pains were significantly lower in the first group as compared with the second one: 1.3+/-0.9 vs 6.2+/-4.5 days; 82.5+/-22.7 vs 557.1+/-212 ml; and 1.9+/-0.8 vs 6.1+/-1.2 points respectively. The number of postoperative complications was almost the same. All the patients were followed up during 24-96 months. There were no thymoma recurrences in the both groups. No statistical differences were found in MG course between the groups. A conclusion is made that VATS removing of noninvasive thymoma is technically feasible and safe for the patients. VATS thymectomy can provide the same results in MG treatment as the open approaches.