Background: To explore the efficacy of combined transcervical and bilateral-thoracoscopic extended thymectomy approach for myasthenia gravis (MG) with thymoma stage I or II.
Methods: From January 2014 to present, patients with thymoma with MG were enrolled into this study. All the patients were diagnosed and well prepared by a multidisciplinary team, including neurologists, ICU physicians and surgeons. All the operations were conducted by the same surgical team with the same approach: combined transcervical and bilateral-thoracoscopic extended thymectomy.
Results: A total of 16 patients were recruited. Their mean age was 44 years, nine patients were females, and six were males. The patients in Osserman classification were 5 in grade I, 6 in grade IIa, 4 in grade IIb, and 1 in grade III. The patients in Masaoka classification were 7 in grade I, and 9 in grade II. The disease duration ranged from 0.5 to 84 months. The mean length of surgery was 109 (range, 80–140) min. Intraoperative blood loss was ranging from 30 to 100 mL. No case sustained myasthenic crisis perioperatively. The pathology analysis indicated that subgroup distribution was AB/B1/B2, 5/5/6. Three cases were found to have ectopic thymus in the neck, with pathology proved. During the follow-up, no tumor recurrence was found and three cases achieved complete remission during the first year after operation, while for the others remains unclear.
Conclusions: Our primary result suggested the combined transcervical and bilateral-thoracoscopic extended thymectomy approach could achieve a curative resection and good cosmesis in myasthenic patients with stage I or II thymoma.