One hundred consecutive thymectomies for myasthenia gravis

Ann Thorac Surg. 1996 Jul;62(1):242-5. doi: 10.1016/0003-4975(96)00202-0.


Background: Between June 1997 and November 1993, 100 consecutive thymectomies for myasthenia gravis were performed at University of North Carolina Hospitals in Chapel Hill.

Methods: A consistent, planned protocol involving preoperative, intraoperative, and postoperative care was followed. All thymectomies were performed through a median sternotomy with removal of all visible thymus and perithymic fat in the anterior mediastinum.

Results: There was no perioperative mortality or longterm morbidity. Mean postoperative hospital stay was 6.3 days (range, 3 to 18 days). Ninety-six percent of the patients were extubated the day of the operation, and all patients were extubated within 24 hours. Mean postoperative intensive care unit stay was 1.2 days (range, 1 to 4 days). After a mean follow-up of 65 months (range, 1 to 199 months), 78% of all patients are improved by at least one modified Osserman classification when their current status is compared with their worst preoperative disease severity. In fact, 69% of patients with mild disease preoperatively (class I, II, or III maximal severity) are in pharmacologic remission (asymptomatic without regular medication), whereas 29% of patients with severe disease (class IV or V) are in remission (p = 0.0001).

Conclusions: Our programmatic approach to thymectomy through a sternotomy has shown minimal morbidity and mortality. It is beneficial to myasthenics at both ends of the age and severity spectrum.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Morbidity
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / epidemiology
  • Myasthenia Gravis / surgery*
  • Postoperative Complications / epidemiology
  • Severity of Illness Index
  • Sternum / surgery
  • Thymectomy / methods*
  • Thymectomy / statistics & numerical data
  • Time Factors