Thymectomy in Myasthenia Gravis

Abstract

ABSTRACT: BACKGROUND: Thymectomy is a good option for the treatment of patients with myasthenia gravis (MG).OBJECTIVE: To show the effect of thymectomy as treatment for patients with myasthenia gravis.PATIENT AND METHODS: A retrospective study of 75 patients admitted to AL-Hariri martyr hospital from January 2010 to December 2014. They were reviewed using special form included patients' (age, sex, hospitalization period, CT-findings, preoperative medication, respiratory care unit (RCU) admissions, plasmapheresis sessions, number of drains in operation, complications post operatively, type of surgery, histopathological findings) with their symptoms being staged according to Osserman classification. All patients managed with trans-sternal thymectomy and extensive tissue removal of the thymus and fatty tissue around it. RESULTS:From 75 patients, 33% achieved complete remission, 27% had partial improvement, 32% with no changes and 8% got worse. 45 patients (60%) are between 20ys and 40ys with female predominance and good responses to surgery. 30 patients (40%) are above 40 with less improvement after thymectomy. Patients with severe symptoms (32 patients) appear to improve. This is also true in patients underwent thymectomy and the histopathological findings of thymic follicular hyperplasia (35 patients). CONCLUSION: Trans-sternal thymectomy is a safe treating method for patients with myasthenia gravis. Age, sex of the patients and presence or absences of thymoma are significant predictors. Patients with severe symptoms and those with a biopsy of thymic follicular hyperplasia improve remarkably.