Subscribe to RSS
DOI: 10.1055/s-0029-1191442
Outcome after thymectomy in myasthenia gravis patients
Aim: Evaluating the surgical and neurological outcome and quality of life in patients having undergone thymectomy for Myasthenia Gravis (MG).
Methods: All consecutive patients (n=216) that underwent thymectomy for MG between 1987 and 2008 were analysed retrospectively. Patients were divided into 2 groups: Group A (n=160) MG without thymoma and group B (n=56) MG with thymoma. We investigated differences in surgical and neurological outcome between patients with and without thymoma. Quality of life was assessed using the SF-36 questionnaire.
Results: The follow-up time was 6 months to 22 years. Although MG was more progressive in group B, the preoperative MG classification did not differ. Patients of group A had more time between the first clinical signs of MG to diagnosis and operative therapy, than patients of group B. Postoperative infection was found in 2 patients (3.56%) of group B, compared to 1 (0.6%) in group A. The phrenic nerve was injured or resected 7 times (12.5%) in group B (in all cases Masaoka Stage ≥3), compared to 1 (0.6%) in group A. There were 4 R2 and 3 R1 thymoma resections. The disease free survival time was longer in group B than in group A. In group B, more patients achieved remission compared to group A. After relapse of MG the symptoms were predominantly mild in both groups. Quality of life improved in both groups after thymectomy.
Conclusion: In addition to pharmacological therapy thymectomy can be a safe and highly effective treatment for MG with or without thymoma.