Comparison of open and minimally invasive thymectomies at a single institution

Am J Surg. 2010 May;199(5):589-93. doi: 10.1016/j.amjsurg.2010.01.001.

Abstract

Background: Most thymectomies are performed via sternotomy. Minimally invasive thymectomy (MIT) has been described but its potential benefits and drawbacks remain unclear.

Methods: A retrospective chart review comparing thymectomies performed via sternotomy to MIT at a single institution between 2005 and 2009.

Results: Eight patients underwent MIT and 8 patients underwent sternotomy in the management of myasthenia gravis, thymic hyperplasia, or small thymic tumors. There was 1 perioperative death unrelated to the surgical procedure and no morbidity. The surgical time, estimated blood loss, and chest tube output was similar in both groups. The average hospital stay for MIT was 2.4 days compared with 4.3 days for sternotomy. One MIT patient remained on narcotic pain medication 2 weeks after surgery compared with 6 in the open group.

Conclusions: MIT can be performed with similar morbidity and efficacy as transsternal thymectomy. Patients require fewer narcotics and can be discharged earlier.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Myasthenia Gravis / mortality
  • Myasthenia Gravis / pathology
  • Myasthenia Gravis / surgery
  • Pain, Postoperative
  • Postoperative Complications / physiopathology
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Robotics / methods*
  • Statistics, Nonparametric
  • Sternotomy / adverse effects
  • Sternotomy / methods*
  • Survival Rate
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / methods*
  • Thymectomy / methods*
  • Thymus Neoplasms / mortality
  • Thymus Neoplasms / pathology
  • Thymus Neoplasms / surgery*
  • Treatment Outcome
  • Young Adult