Surgery for myasthenia gravis

The effect of thymectomy on myasthenia gravis was evaluated in the 48 patients with thymectomy for myasthenia gravis in the First Department of Surgery, Nagasaki University School of Medicine. The surgical approaches were done by midsternotomy in 44, by right thoractomy in 3 and by transcervical route in 1 respectively. As a rule, extended thymectomy was mainly applied. The disease stages in most cases included the types of Osserman II b and/or II a. The effect of thymectomy on myasthenia gravis was compared between the patients with and without thymoma. The effect of thymectomy for patients without thymoma was superior to that for patients with thymoma. There was no close relationship between the suffering time and the effect of thymectomy. Interestingly enough, the surgical outcome for those who had moderate or severe formation of germinal center in the resected thymic glands was not satisfactory and some aggravated following thymectomy.