[Minimally invasive thymectomy with videothoracoscopy via the right chest]

The authors present the technique and results of minimally invasive thymectomy via the right chest based on their clinical practice.

Between 1 June 2009 and 31 March 2011 27 patients (22 females, 5 males; mean age 35.1 [17-84] years) underwent thymectomy without sternotomy at the division of thoracic surgery of the Department of Surgery, University of Szeged. Indications were myasthenia gravis in 24 and thymoma in 3 patients. The incisions were the following: two 1.5 cm in the right breast fold and one 3 cm incisions in the axillara. There were no incisions in the neck or no sternotomy was carried out either. Preparation and removal of the thymus were performed by conventional and endoscopic instruments, and a drain was inserted into the right chest cavity up until the mediastinum.

Mean time for surgery was 119 minutes (45-285). There was no conversion and no transfusion needed. Further, there was no surgical mortality or morbidity detected. Mean time for chest drain removal was 2.05 (1-3) days, and mean length of hospital stay was 4.56 (4-7) days. Two patients were admitted to the intensive care unit for myasthenia symptoms. Importantly, myasthenia gravis improved in 91.6% of the patients.

Minimally invasive thymectomy is a safe procedure with excellent cosmetic results. Improvement in myasthenia gravis was similar to published literature data.