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DOI: 10.1055/s-2008-1037970
Surgical and neurological outcome of thymectomy for myasthenia gravis
Aim: To evaluate the surgical and neurological outcome and quality of life in patients having undergone thymectomy for Myasthenia Gravis (MG).
Methods: All consecutive patients (n=206) that underwent thymectomy for MG between 1987 and 2007 were analysed retrospectively. Patients were divided into 2 groups: Group A (n=152) MG without thymoma and group B (n=54) 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 20 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 (3.7%) of group B, compared to 1 (0.7%) in group A. The phrenic nerve was injured or resected 7 times (13%) in group B (in all cases Masaoka Stage ≥3), compared to 1 (0.7%) in group A. There were 4 R2 and 3 R1 thymoma resections. The disease free survival 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 is almost that of the SF-36 normpopulation 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.