• Adele Tessitore, Maria Letizia Vita, Giacomo Cusumano, Maria Teresa Congedo, Mariella Filotico, Elisa Meacci, Venanzio Porziella, Stefano Margaritora, and Pierluigi Granone.
• Unità Operativa di Chirurgia Toracica, Policlinico Universitario A. Gemelli, Roma. adeletessi@tiscali.it
• Ann Ital Chir. 2007 Sep 1; 78 (5): 355-8.

ObjectiveWe describe the technique, the benefits and the drawbacks of an original video-assisted thymectomy (VAT), performed through an inframammary cosmetic incision and median sternotomy in myasthenia gravis (MG) patients. This procedure is clinically valuable and cosmetically satisfactory so as to be very well accepted by patients, especially by young women. Minimal-access thymectomy has become increasingly popular as surgical treatment for patients with nonthymomatous myasthenia gravis because of its comparable efficacy, safety, and lesser degree of tissue trauma with conventional open surgery.MethodsWe report a review/interview of 180 MG patients treated between 1993 and 2005. According to Myasthenia Gravis Foundation of America (MGFA), complete stable remission (CSR) and pharmacologic remission (PR) were calculated at the end of a minimal period of 12 months.ResultsA clinical remission was obtained in 41.1% (CR 27.8%, PR 13.3%), who had been followed for at least 12 months from surgery. 95% of these patients judged their cosmetic results to be excellent or good.ConclusionsThymectomy in MG video-assisted infra-mammary cosmetic incision has shown to be a useful surgical approach as demonstrated by the good functional and very good aesthetic results, associated with a very low morbidity and no mortality.

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