Radicality of thoracoscopic thymectomy – an anatomical study

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Abstract
Evidence suggests that there is a direct relationship between the completeness of thymectomy (Thx) and outcome of myasthenia gravis (MG) [1]. The question of the most suitable surgical approach is still controversial [2,3]. The main drawback of all approaches traditionally competing with median sternotomy is their lack of radicality [1,3]. An anatomical study therefore investigated the radicality of Thx using the new thoracoscopic approach (tThx) and the question which side should be preferred for tThx. After approval by the Ethics Committee and informed consent by the next of kin, ten consecutive human cadavers were alternately assigned to left- or right-sided tThx. Eight special locations within the anterior mediastinum were evaluated for complete dissection: the main thymic lobes, the pretracheal tissue, the tissue behind the phrenic nerve and anonymous vein, the aorto-pulmonary window, the aorto-caval groove, and the pericardio-phrenic tissue. tThx was performed as described earlier [2,4], comparing the 0 and 30° telescopes during each procedure.

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