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Exploring the efficacy of a modified combined minimally invasive approach in patients with thymoma regardless of myasthenia gravis involvement in contrast to open surgery as the mainstay of treatment. Primary epithelial thymic tumours are rare malignancies of the anterior mediastinum, often present with myasthenia gravis, and with good prognosis when assuming complete surgical resection. We present amodified mini-invasive technique (MIT) that is unique in its extent. Fifty-two patients were included in this retrospective study. Two grou