Thymectomy

Thymectomy is surgical removal of the thymus gland. In myasthenia gravis, the thymus is often abnormal and removing it can improve symptoms or lead to remission.

Why It's Done

Required

• Thymoma (tumor of thymus)—must be removed
• Thymic carcinoma

Recommended

• Generalized myasthenia with AChR antibodies
• Patients under 60-65 years
• May improve symptoms and medication needs

Less Clear Benefit

• Ocular myasthenia only
• Older patients
• Antibody-negative myasthenia

The Procedure

Approaches

• VATS (video-assisted thoracoscopic surgery)—minimally invasive
• Robotic surgery—minimally invasive
• Sternotomy—open chest (less common now)
• Transcervical—through neck

What to Expect

• General anesthesia
• 1-4 hours depending on approach
• Hospital stay 1-4 days
• Recovery weeks to months

Results

MGTX Trial Findings

• Improved symptoms in many patients
• Reduced medication needs
• Benefits may take 2-3 years to fully appear
• 36% achieved minimal manifestations status

Thymoma Removal

• Prevents tumor growth/spread
• May or may not improve MG symptoms

Risks

• Bleeding
• Infection
• Nerve injury
• Myasthenic crisis (temporary worsening)
• Anesthesia risks

After Surgery

• Gradual return to activities
• Continue MG medications (may reduce later)
• Regular neurology follow-up
• Monitor for improvement over years