Paradigm shift in surgical approaches to thymectomy

Background: Thymectomy is an established therapy in the management of myasthenia gravis (MG) used in conjunction with medical treatment. The optimal surgical approach to thymectomy, however, has remained controversial. Method: The present review discusses the author's experiences of and the literature regarding the management of MG using the video-assisted thoracic surgery (VATS) approach. Results: This approach was shown to be technically safe in experienced hands and associated with less postoperative pain, better preservation Of lung function in the early postoperative period and better cosmetic results than alternative techniques. The intermediate term results of VATS are comparable to those of more radical approaches. It is hoped that this patient-friendly approach will lead to greater support by patients and their neurologists. for earlier surgery. Conclusion: VATS is an attractive, alternative approach to thymectomy.