Infrasternal mediastinoscopic thymectomy in myasthenia gravis: Surgical results in 23 patients

Akihiko Uchiyama, Shuji Shimizu, Hiroyuki Murai, Syoji Kuroki, Masayuki Okido, Masao Tanaka

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)


Background. Infrasternal mediastinoscopic surgery is a new approach to resection of the anterior mediastinal mass. Methods. We evaluated this new approach in 23 patients with myasthenia gravis who underwent total thymectomy assisted by infrasternal mediastinoscopy between 1998 and 2000. The results were analyzed with special reference to morbidity and short-term improvement of the disease severity determined according to quantitative myasthenia gravis (QMG) scores. Results. Complete removal of the thymic gland with the pericardial adipose tissue was accomplished through an infrasternal mediastinoscopic approach in 21 of the 23 (91.3%) patients. The remaining 2 patients required conversion to sternotomy, the one for insufficient sternal lifting with vascular tape and the other for invasion of a thymoma to the innominate vein. There was no related mortality and only one complication, a phrenic nerve injury in 1 patient (4.3%). Significant clinical improvement of disease was achieved in the short term and several advantages were apparent. Conclusions. Infrasternal mediastinoscopic thymectomy is safe and feasible for patients with myasthenia gravis.

Original languageEnglish
Pages (from-to)1902-1905
Number of pages4
JournalAnnals of Thoracic Surgery
Issue number6
Publication statusPublished - 2001

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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