Safety and feasibility of video assisted thoracoscopic thymectomy for myasthenia gravis: a single centre experience

Authors

  • Raj N. Gajbhiye Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India
  • Hemant Bhanarkar Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India
  • Vikrant V. Akulwar Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India
  • Bhupesh Tirpude Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India
  • Niketan Jambhulkar Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India
  • Gayatri Deshpande Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20192385

Keywords:

Myasthenia gravis, Thymoma, Video assisted thoracoscopic thymectomy

Abstract

Background: Myasthenia gravis (MG) is an autoimmune disease affecting acetylcholine postsynaptic receptor of voluntary muscles. Thymectomy is a mainstay in the treatment for myasthenia gravis with or without thymoma. For many years transsternal and transcervical thymectomy had been the most common approaches used, video assisted thoracoscopic thymectomy is still not accepted as approach of choice. We intend to study the role of Video assisted thoracoscopic thymectomy for myasthenia gravis in central Indian population.

Methods: Study was conducted in single tertiary care institute from January 2015 to November 2018. It is a prospective study. Aims of the study were to evaluate the safety and feasibility of video assisted thoracoscopic thymectomy for patients of myasthenia gravis. All patients of myasthenia gravis who underwent underwent video assisted thoracoscopic thymectomy (VATS) were included in the study. Intraoperative and postoperative details were studied to assess the safety and feasibility of VATS for treatment of myasthenia gravis.

Results: 16 patients including 7 men and 9 women with the mean age of 35.5 years were investigated. All patients had myasthenia gravis, 12 pts had thymoma while remaining 4 pts had normal thymus. Mean operating time was 104 mins, Mean intraoperative blood loss was 45 ml (range 20 to 60 ml). There was no major intraoperative or postoperative complication or mortality. Mean ICU stay and hospital stay was 33 hrs and 4.25 days respectively.

Conclusions: VATS thymectomy is safe and effective approach for the treatment of MG with or without thymoma. MG treated by VATS resulted in comparable neurological outcomes to those associated with the transsternal approach.

Author Biographies

Raj N. Gajbhiye, Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

Professor and Head, Department of surgery, Government medical college, Nagpur. Maharashtra. India.

Hemant Bhanarkar, Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

Assistant Professor, Department of surgery, Government medical college, Nagpur. Maharashtra. India.

Vikrant V. Akulwar, Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

Assistant Professor, Department of surgery, Government medical college, Nagpur. Maharashtra. India.

Bhupesh Tirpude, Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

Associate Professor, Department of surgery, Government medical college, Nagpur. Maharashtra. India.

Niketan Jambhulkar, Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

Associate Professor, Department of Surgery, Government medical college, Nagpur. Maharashtra. India.

Gayatri Deshpande, Department of Surgery, Government of Medical College and Hospital, Nagpur, Maharashtra, India

Assistant Professor, Department of Surgery, Government medical college, Nagpur. Maharashtra. India.

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Published

2019-05-28

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Original Research Articles