Thymectomy for Myasthenia Gravis

Overview
A thymectomy is a type of surgery to remove the thymus gland. It’s a common procedure for treating myasthenia gravis. Doctors frequently recommended thymectomy for people under the age of 60 living with moderate to severe weakness related to myasthenia gravis. Doctors also sometimes recommend the surgery for people of any age living with myasthenia gravis who have a thymic tumor and/or who have relatively mild weakness, especially weakness that affects their breathing or swallowing.

What does it involve?
There are several ways to perform a thymectomy, some of which are less invasive than others.

The transsternal approach begins with a sternotomy, during which a surgeon fully or partially divides a person’s sternum (breastbone). Through the incision, they will then remove the thymus and any affected tissue. Next, they’ll insert one or two tubes to drain the area. Finally, they’ll close the sternum using wires, then close the skin.

A second approach is called transcervical, which is less invasive. This procedure begins with an incision across the lower part of the neck, near the sternum. A surgeon then removes the thymus through the opening.

Video-assisted thoracoscopic thymectomy (VATS) is considered a minimally invasive approach. It begins with a surgeon inserting three ports into one side of the chest. One of these ports will provide access for an endoscope (camera). From there, the surgeon will either use special surgical tools or robotic arms to extract the thymus, along with any tumor. All of the tissue will be placed in a bag within the chest and removed via an incision. One or two tubes will then be inserted into the chest for draining. Medication will be applied within the chest wall to relieve postoperative pain. Finally, the surgeon will remove the ports and close the incisions.

Following a thymectomy, the recipient’s breathing tube is removed and they will be transferred to a recovery room. A person will often be transferred to a regular room the same day they undergo the thymectomy. Recovery time varies depending on the type of surgery, but most people remain in the hospital for at least one night.

Side effects
Potential risks or complications associated with thymectomy include injury to the heart, a nerve, or a blood vessel; bleeding and damage to surrounding veins; a collapsed lung; pneumonia; and blood or lymphatic fluid between the lungs and the chest wall. Very rarely, stress from having surgery may cause a myasthenic crisis (worsening of muscle weakness which can lead to respiratory failure).

For more details about this treatment, visit:

Thymectomy — Cleveland Clinic
https://my.clevelandclinic.org/health/treatment...

Thymectomy — Myasthenia Gravis Foundation of America
https://myasthenia.org/MG-Education/Learn-More-...

Thymectomy — StatPearls
https://www.ncbi.nlm.nih.gov/books/NBK564302/