Factors affecting response rates after thymectomy for myasthenia gravis

Abstract

Aim In our study, we report the clinical response obtained after transsternal extended thymectomy (TSET), the factors affecting the response, and the most appropriate timing of the operation.Methods A total of 35 cases underwent TSET with the diagnosis of myasthenia gravis in our department from December 1996-June 2015. Twenty of the cases were females (57%) and fifteen (43%) were males with a mean age of 42±15 (14-68). The case registry has been analyzed retrospectively.Results Postoperative histopathological examination revealed non-thymoma thymic pathologies in 19 (54%), thymoma in 16 (46%). Myasthenia gravis symptoms were staged according to the Osserman classification: 8 (22,9%) were stage I, 13 (37,1% ) were stage IIa, 11 (31,4%) were stage IIb, and 3 (8,6%) were stage III, with no patients at stage IV. The duration of symptoms of <24 month before the operation was statistically significant for groups with and without thymoma (p< 0,001). However, parameters of age, gender, preoperative Osserman stage, and pathological diagnosis were not
statistically significant between groups.Conclusion Transsternal extended thymectomy allows for extended removal of all the mediastinal tissue in the anterior mediastinum with a low complication rate. Symptom duration before operation is the most important factor in response to treatment; therefore, patients must be operated on as soon as possible. Thymectomy also seems to be helpful for early stage MG.

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