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The Annals of Thoracic Surgery, Vol 47, 838-840, Copyright © 1989 by The Society of Thoracic Surgeons
PD Hatton, JT Diehl, BD Daly, HF Rheinlander, H Johnson, JB Schrader, M Bloom and RJ Cleveland
Thymectomy is an accepted therapeutic modality for patients with myasthenia
gravis. The selection of patients for operation and the surgical approach
are controversial. We reviewed 52 patients (aged 18 months to 82 years;
mean age, 34 years) treated with transsternal radical thymectomy between
1972 and 1987. Patients were symptomatically staged according to the
modified Osserman classification. There was one hospital death and
postoperative follow-up was obtained on 51 patients. Improvement after
thymectomy was observed in 3 of 11 patients (27%) in Osserman stage I, 16
of 25 patients (64%) in Osserman stage IIA, and 13 of 15 patients (86%) in
combined Osserman stages IIB, III, and IV. Preoperative Osserman stage,
patient sex, and thymic histology correlated with postoperative clinical
response. Transsternal radical thymectomy is effective therapy for
myasthenia gravis. Sustained improvement is obtained in patients with
moderate and advanced disease. The majority of patients with ocular disease
do not benefit from operation.
ARTICLES
Transsternal radical thymectomy for myasthenia gravis: a 15-year review
Department of Cardiothoracic Surgery, New England Medical Center Hospitals, Boston, MA 02127.
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