THYMECTOMY FOR MYASTHENIA-GRAVIS

Myasthenia gravis is a relatively uncommon antoimmune disorder of neur omuscular transmission. Surgical therapy plays an important role in ad dition to medical treatment. Follow-up results of 52 patients with thy mectomy are presented. Between 1984-1996 thymectomy via median sternot omy was performed in 52 patients with myasthenia gravis (female = 28, male = 24). The score described by Ossermann and Genkins was used for classification. According to this classification, we found 12 patients in class III, 21 in class IIA, 17 in class IIB and 2 in class III, re spectively. A thymoma was found in 19, follicular lymphoid hyperplasia in 24 and an atrophic thymus in 9 cases, respectively. There was no m ortality. Severe postoperative complications consisted of bleeding and reoperation in one patient and another patient developed a sternal in stability with consecutive operative refixation. Follow-up evaluation after a mean period of 36 months (min. 6 months, max. 130 months) reve aled a relief of myasthenic symptoms in 37 patients. Thymectomy is eff ective in the treatment of myasthenia gravis with a low complication r ate.