1997 Volume 11 Issue 2 Pages 181-185
We performed a mediastinoscopic extended thymectomy using a sternum lifting method on a patient with myasthenia gravis without thymoma. We reported this surgical method, focusing on its technique. The papient was a 42-year old female with myasthenia gravis, II B under Osserman classification.
First, the thymic tissue from the inferior pole of the thyroid gland up to the superior mediastinum was detached by a cervical collar incision. Next, after the entire sternum was elevated using a strip of tape inserted in the longitudinal axial direction, the thymes, including the anterior mediastinal fat tissue, was removed under the mediastinoscope.
The surgical procedure was completed in 5 and a half hours, with a 200cc hemorrhage, and the removed thymus weighed 42g. There was hardly any postoperative pain due to the sternum elevation and mediastinal maneuver.
With this technique, an extended thymectomy which is equivalent to a midline sternotomy approach can be accomplished. Moreover, it is a more safely applicable method to pleurodesis cases and pulmonary insufficiency cases with a dysfunctional ventilation lung.
