Outcome of Thymectomy in Myasthenia Gravis Patients

Sherif, Abdelhamid; Aglan, Basem; Abd-Ellatif, Anhar

doi:10.21608/bmfj.2023.215030.1832

Outcome of Thymectomy in Myasthenia Gravis Patients

Document Type : Original Article

Authors

¹ M.D , Lecutrer of Cardiothoracic surgery Banha University

² cardio thoracic surgery department Benha university

³ Cardiothoracic surgery department, Faculty of Medicine, Benha University, Egypt

10.21608/bmfj.2023.215030.1832

Abstract

Background: Myasthenia gravis (MG) impairs voluntary muscle function by targeting the postsynaptic acetylcholine receptors, causing weakness and fatigue in the affected muscle group. This study aimed to assess the outcomes of thymectomy in MG patients, measure the extent of clinical improvement post-thymectomy by analyzing changes in disease stage and medication needs, and identify prognostic factors that can aid in determining the most suitable patient selection.
Methods: This prospective study was carried out on 53 patients aged greater than or equal to 18 years old, both sexes, scheduled for MG and underwent transsternal and VATS total thymectomy. Before surgery, each patient was evaluated by the neurologist and underwent a standard chest x-ray and a chest computed tomography. Both VATS and transsternal thymectomy were used as the surgical options in our study.
Results: The majority of patients who achieved full clinical remission were classified under Osserman stages I, IIA, and III. In terms of the relationship between prognostic factors and complete clinical remission, females had a more favorable outcome following thymectomy (P-value = 0.019). Additionally, younger age was associated with better remission outcomes compared to older age groups (P-value < 0.001).
Conclusions: Thymectomy is recommended for patients younger than 60 years with non-thymomatous, generalized AChR antibody-associated myasthenia gravis. The early-onset MG, severe MG, female sex, and thymic hyperplasia are important factors helping to obtain better postoperative outcome. Thymectomy can reduce patient’ s need for medication and the severity of MG regardless of age, sex, severity, or length of sickness, or thymic masses.

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