Thoracoscopic Thymectomy for Myasthenia Gravis: An early experience in Yemen

Abstract

Background Thymectomy is an option for the treatment of myasthenia gravis MG. While the open technique was most frequently performed in the past, nowadays the endoscopic approach has gained wide acceptance. Here we assessed our early experience in thoracoscopic thymectomy (TT).Methods This case series was retrospectively conducted at Al-Thawra Modern General Hospital and included patients diagnosed with MG who underwent TT from January 2018 to January 2024.Results Our case series consisted of 13 predominantly female patients (61.5%), with a median age of 39.5 years. The most common presenting symptoms were generalized weakness and ptosis. Surgeries typically lasted 50 ± 10.41 minutes, with the majority performed using a left-sided thoracoscopic approach (n = 10, 77%). Immediate extubation was achieved in 10 patients (76%). Four patients experienced early postoperative complications (31%), including dyspnea, prolonged intubation, chest infection, confusion, tracheostomy, and re-tracheostomy. There were 2 recorded deaths due to complications. Eleven patients were followed up for an average of 16.5 months, revealing that 54.5% achieved complete stable remission, 18% showed improvement with reduced symptoms and medications, and 27% remained unchanged.Conclusions Thoracoscopic thymectomy is a safe and effective procedure for the management of MG in Yemeni patients. The observed remission and improvement rates are promising and align with global experiences. It is recommended that with proper resources and expertise, similar minimally invasive surgical approaches can be implemented in resource-limited regions.