Mediastinoscopic extended thymectomy for pediatric patients with myasthenia gravis

作者：Kitagawa N^*; Shinkai M; Take H; Mochizuki K; Asano F; Usui H; Miyagi H; Kido T; Kurauchi N; Osaka H; Yamashita S

来源：Journal of Pediatric Surgery, 2015, 50(4): 528-530.

DOI：10.1016/j.jpedsurg.2014.08.012

• Myasthenia gravis
• Children
• Endoscopic surgery
• Mediastinoscopy

Background: Extended thymectomy is indicated for children with myasthenia gravis (MG) when drug-resistance or dependence is seen. We have employed a technique for mediastinoscopic extended thymectomy (MET) on children with MG.
Method: A total of 14 children underwent MET at Kanagawa Children's Medical Center between 2005 and 2013. A mediastinal operation field was made by a V-shaped hook infrasternally to extirpate the thymus with adipose tissue around the thymus.
Results: The operation time and the amount of blood loss were 182 +/- 44 minutes and 34 +/- 43 ml, respectively. Postoperative complications, in the form of transient paralysis of the right recurrent nerve, occurred in 2 patients. The median length of postoperative hospital stay was 4.5 days. After MET, 6 patients achieved complete remission and 7 patients achieved steroid dose reduction, but no improvement was seen in 1 patient.
Conclusions: This procedure offers the advantage of good surgical access for dissection around the bilateral phrenic nerves in extended total thymectomy, while achieving good cosmetic results.

• 出版日期2015-4