Thymectomy (VATS, da Vinci)

Abstract

Thymectomy is relatively indicated and most frequently performed in patients with the autoimmune disease myasthenia gravis. In particular, the indication for thymectomy, as well as the long-term improvement of myasthenia gravis, may depend on patient-derived factors such as gender, age, the severity of myasthenia, the duration of symptoms, the interval between diagnosis and thymectomy, the presence/absence of a thymoma, the serologic investigation (anti–acetylcholine receptor [anti-AChR], anti–muscle-specific kinase [anti-MuSK], or no antibodies), the amount of medication and necessity of immunosuppression, and other comorbidities. There is an absolute indication for thymectomy in patients with thymoma, an epithelium-derived tumor of the anterior mediastinum that may or may not be accompanied by myasthenia gravis. Other rare indications are ectopic mediastinal intrathymic parathyroid glands and different forms of multiple endocrine neoplasia with anticipated thymic carcinoma.