HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Frank C. Detterbeck Walter W. Scott Thomas M. Egan Peter J. K. Starek Michael R. Mill Benson R. Wilcox Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Detterbeck, F. C. Articles by Wilcox, B. R. Search for Related Content PubMed PubMed Citation Articles by Detterbeck, F. C. Articles by Wilcox, B. R. Related Collections Related Article

Ann Thorac Surg 1996;62:242-245
© 1996 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

One Hundred Consecutive Thymectomies for Myasthenia Gravis

Division of Cardiothoracic Surgery, Department of Surgery, and Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, North CarolinaUSA

Background. Between June 1977 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 long-term 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.

Related Article

Discussion
Ann. Thorac. Surg. 1996 62: 245. [Extract] [Full Text]

This article has been cited by other articles:

				A. Toker, S. Tanju, S. Ziyade, S. Kaya, and S. Dilege Learning curve in videothoracoscopic thymectomy: how many operations and in which situations? Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 155 - 158. [Abstract] [Full Text] [PDF]

				M. Zielinski Patients with myasthenia with oropharyngeal involvement need medical preparation before thymectomy. Ann. Thorac. Surg., May 1, 2008; 85(5): 1842 - 1842. [Full Text] [PDF]

				J. W. Rubin Invited commentary. Ann. Thorac. Surg., September 1, 2006; 82(3): 1007 - 1008. [Full Text] [PDF]

				H. Kattach, K. Anastasiadis, J. Cleuziou, C. Buckley, B. Shine, R. Pillai, and C. Ratnatunga Transsternal Thymectomy for Myasthenia Gravis: Surgical Outcome Ann. Thorac. Surg., January 1, 2006; 81(1): 305 - 308. [Abstract] [Full Text] [PDF]

				M. de Perrot, V. Bril, K. McRae, and S. Keshavjee Impact of minimally invasive trans-cervical thymectomy on outcome in patients with myasthenia gravis Eur. J. Cardiothorac. Surg., November 1, 2003; 24(5): 677 - 683. [Abstract] [Full Text] [PDF]

				P. M. Pego-Fernandes, J. R. M. de Campos, F. B. Jatene, P. Marchiori, F. V. Suso, and S. A. de Oliveira Thymectomy by partial sternotomy for the treatment of myasthenia gravis Ann. Thorac. Surg., July 1, 2002; 74(1): 204 - 208. [Abstract] [Full Text] [PDF]

				J. Kas, D. Kiss, V. Simon, E. Svastics, L. Major, and A. Szobor Decade-long experience with surgical therapy of myasthenia gravis: early complications of 324 transsternal thymectomies Ann. Thorac. Surg., November 1, 2001; 72(5): 1691 - 1697. [Abstract] [Full Text] [PDF]

				A. Mussi, M. Lucchi, L. Murri, R. Ricciardi, L. Luchini, and C. A. Angeletti Extended thymectomy in myasthenia gravis: a team-work of neurologist, thoracic surgeon and anaesthesist may improve the outcome Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 570 - 575. [Abstract] [Full Text] [PDF]

				F. Romi, G. O. Skeie, J. A. Aarli, and N. E. Gilhus The Severity of Myasthenia Gravis Correlates With the Serum Concentration of Titin and Ryanodine Receptor Antibodies Arch Neurol, November 1, 2000; 57(11): 1596 - 1600. [Abstract] [Full Text] [PDF]