Trans-sternal thymectomy in myasthenia gravis

Between 1986 and 1989 27 patients with myasthenia gravis underwent radical thymectomy: 24 patients without and two patients with thymoma through a trans-sternal incision, another with thymomatous myasthenia through a left-sided thoracotomy. The patients were staged according to the modified Ossermann classification. The results were evaluated prospectively according to the Disability Status Scale of Oosterhuis. During a mean follow up of 22.4 months, 21 patients (77%) benefited from the operation with complete remission achieved in 9 (33%) and significant improvement noted in 12 (44%). There were no operative deaths and no hospital morbidity. The mean operation time was 88 minutes, the mean postoperative hospital stay 10.5 days. These results support the recommendation for radical trans-sternal thymectomy in the treatment of patients with myasthenia gravis as a safe procedure.