In recent years, thymectomy has become a widespread procedure in the treatment of myasthenia gravis (MG). Likelihood of remission was highest in preoperative mild disease classification (Osserman classification 1, 2A). In absence of thymoma or hyperplasia, there was no relationship between age and gender in remission with thymectomy. In MG treatment, randomized trials that compare conservative treatment with thymectomy have started, recently. As with non-randomized trials, remission with thymectomy in MG treatment was better than conservative treatment with only medication. There are four major methods for the surgical approach: transcervical, minimally invasive, transsternal, and combined transcervical transsternal thymectomy. Transsternal approach with thymectomy is the accepted standard surgical approach for many years. In recent years, the incidence of thymectomy has been increasing with minimally invasive techniques using thoracoscopic and robotic methods. There are not any randomized, controlled studies which are comparing surgical techniques. However, when comparing non-randomized trials, it is seen that minimally invasive thymectomy approaches give similar results to more aggressive approaches.Keywords: Extended thymectomy, follow-up, myasthenia gravis, thoracoscopic thymectomy ÖZ Miyastenia gravis tedavisinde son yıllarda timektomi giderek yaygınlaşan bir prosedür haline geldi. Preoperatif hafif hastalık sınıflaması (Osserman sınıflaması 1, 2A) olanlarda remisyon ihtimali en yüksek olarak gösterildi. Timoma veya hiperplazi yokluğunda timektomi ile remisyon sağlamada yaş ve cinsiyetin ilişkisi gösterilemedi. Miyastenia gravis tedavisinde timektomi ile konservatif tedaviyi karşılatıran randomize çalışmalar yeni yayınlanmaya başlandı. Nonrandomize çalışmalarda olduğu gibi Miyastenia gravis tedavisinde timektomi ile remisyon, sadece ilaçla konservatif tedaviden daha iyi bulundu. Cerrahi yaklaşım için transservikal, minimal invaziv, transsternal ve kombine transservikal transsternal timektomi olmak üzere dört major yöntem bulunmaktadır. Transsternal yaklaşımla timektomi yıllardır kabul gören standart cerrahi yaklaşımdır. Son yıllarda torakoskopik ve robotik yöntemin kullanıldığı minimal invaziv tekniklerle timektomi sıklığı artmaktadır. Cerrahi teknikleri karşılaştıran randomize, kontrollü çalışmalar bulunmamaktadır. Ancak nonrandimize çalışmalar arasındaki karşılaştırmalara bakıldığında minimal invaziv timektomi yaklaşımlarının daha agresif yaklaşımlara benzer sonuçlar verdiği görülmektedir.

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Type B1 thymoma (lipofibroadenoma) is extremely rare. The tumor is characterized by an organoid appearance rich in lymphocytes with medullary differentiation and perivascular spaces. A twenty-threeyear-old female patient was admitted to our clinic with complaints of chest pain and dyspnea for six months. Chest computed tomography showed solid and fatty components of masses 21×7 and 5×7 cm with clear borders in the right thoracic cavity. The patient underwent a posterolateral thoracotomy in which the mass, arising from the anterior mediastinum, was resected. Histopathological examination showed that the mass was Type B1 thymoma, and the patient was presented in light of the literature. Key Words: Lipofibroadenoma, Mediastinum, Thymoma ÖzetTip B1 timoma (lipofibroadenoma) oldukça nadirdir. Tümör medül-ler farklılaşma ve perivasküler aralık ile lenfositten zengin organoid bir görünümle karakterizedir. Yirmi üç yaşında bir bayan olgu altı ay önce başlayan göğüs ağrısı ve nefes darlığı şikâyetleri ile kliniğimize başvurdu. Toraks bilgisayarlı tomografide sağ torasik kavitede düz-gün kenarlı solid ve yağ dansiteleri içeren bir kitle (21×7, 5×7 cm) görüldü. Olguya uygulanan posterolateral torakotomide anterior mediastenden kaynaklanan bir kitle tespit edilip rezeke edildi. Histopatolojik inceleme Tip B1 timoma olarak bildirilen olgu literatür bilgileri ışığında sunuldu.

Background: In this study, we aimed to evaluate the efficacy and safety of primary laparoscopic repair of Morgagni hernia. Methods: In this retrospective study, a total of 12 patients (4 males, 8 females; mean age 56.5±14.9 years; range, 32 to 80 years) who underwent primary laparoscopic repair for Morgagni hernia between January 2014 and December 2019 were included. In all cases, the hernia sac was excised and the defect was repaired primarily with non-absorbable sutures. Results: All patients had excellent outcomes and were uneventfully discharged from the hospital after a mean length of hospital stay of 4.6±1.3 days (range, 3 to 7 days). No mortality, morbidity or recurrence were observed in any of the patients. Conclusion: The primary laparoscopic repair is an effective and safe approach to surgical repair for Morgagni hernia in experienced hands.

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