MORBIDITY AFTER TRANSSTERNAL THYMECTOMY FOR MYASTHENIA-GRAVIS - A CHANGING PERSPECTIVE

A detailed assessment of recent changes in morbidity and mortality aft er transsternal thymectomy for myasthenia gravis is pending. To this e nd, a retrospective analysis was carried out of morbidity and mortalit y rates in 125 patients subjected to transsternal thymectomy for myast henia gravis in the periods 1976-85 (1(st) decade) and 1986-95 (2(nd) decade). Composition of patients did not change much over time, except for more concomitant preoperative disease in the second decade (p = 0 .001). None the less, complication rates were not higher, nor did the pattern of complications alter. Mortality was nil in both decades. The re was no difference over the decades as to length of ventilation, int ensive care treatment, or overall hospitalization. Most complications did not reveal a monocausal relationship, suggesting that a combinatio n of risk factors was implicated. Futher reductions in future morbidit y rates after transsternal thymectomy for myasthenia gravis seem unlik ely as patient preoperative state is unlikely to improve. In the light of the deteriorating preoperative patient condition, constant postope rative morbidity rates indicate that patient care has in fact improved .