Objective To explore the clinical efficacy of twoport videoassisted thoracoscopic surgery (VATS) for thymoma complicated with myasthenia gravis (MG). Methods Nine patients with thymoma complicated with myasthenia gravis underwent twoport videoassisted thoracoscopic surgery. A incision with length of 1.5 to 2 cm was performed at the 5th or 6th intercostal space of right midaxillary line, and was taken as the observation hole and auxiliary operation hole. A incision with length of 2 to 4 cm was performed at the 3th or 4th intercostal space of right anterior axillary line, and was taken as the main operating hole. Tumor and anterior mediastinum adipose tissues were resected in all of the cases. Results ALL of the operations were completed under thoracoscope guidance without conversion to open thoracotomy. No myasthenia crisis and other serious complications observed in any cases. No deaths occurred. The mean operative duration was 110 min (range, 90 to 180 min), the mean introperative blood loss was 150 mL (range, 30 to 250 mL) and the mean hospital stay was 8.3 d (range, 7 to 10 d). Seven patients were followed up for 7 to 10 d (mean, 8.3d). During the followup, no recurrences, metastasis and aggravation of MG were found in any of cases. Conclusions Twoport videoassisted thoracoscopic surgery is a safe and reliable approach for patients with thymoma complicated with myasthenia gravis. And it has lower incidence rate of complications and shorter recovery time.

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