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Myasthenia Gravis

Thymus surgery

12/17/2007

Question:

what can affect after surgery?can be others complications?explain them please

Answer:

Thymectomy is one treatment for myasthenia gravis, and it is not without risk. It can be very useful for certain myasthenics, especially young myasthenics with generalized seropositive myasthenia. But it is not a guaranteed cure. If there is a clear thymic mass or thymic tumor (thymoma), then it seems like it may be useful. Remission after thymectomy at 7-10 years is 40-60% (except patients with thymoma who have a lower remission rate).

Thymectomy is a surgical procedure, requiring anesthesia (which can worsen myasthenia). It can have local bleeding and infection associated with it. There are different techniques (transcervical, transsternal, and laparoscopic), and you need a surgeon who is experienced in the procedure. I have seen complications ranging from bleeding, infection, bile duct damage, to phrenic nerve damage (causing weakness of the diaphragm, making it harder to breathe). Ask the surgeon what his/her individual morbidity/mortality rates are, and what the risks of the procedure are.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati