An Overview of Thymectomy Approaches among Myasthenia Graves Patients: Review Article

Abstract

Background: Myasthenia gravis (MG) is a syndrome characterized by fatigue-and activity-induced improvements in skeletal muscular weakening. There is a wide range of possible involvement, including but not limited to the muscles of the eyes, face, oropharynx, trunk, and limbs. Once the patient's level of weakness has been managed to the point that surgery is possible, thymectomy is recommended. Preoperatively, patients are typically treated with mild doses of intravenous immunoglobulins as well as glucocorticoids. Objective: Review of the literature on thymectomy approaches among myasthenia graves' patients. Methods: We scoured medical journals and databases including PubMed, Google Scholar, and Science Direct for information on thymectomy and myasthenia graves. Between September 2006 and August 2022, however, only the latest or most comprehensive study was considered. The authors also assessed the usefulness of references drawn from similar books. Documents written in languages other than English have been overlooked because of lack of funding to translate them. Unpublished articles, oral talks, conference abstracts, and dissertations were all generally agreed upon not to constitute valid scientific investigation. Conclusion: It has been argued that a maximum thymectomy, in which both the transsternal and transcervical techniques are used on the same MG patient, yields superior results. After extensive transsternal thymectomy or video-assisted thoracoscopic thymectomy, half of patients with non-thymomatous MG had complete stable remissions at 6 years of follow-up.

Outcome of Thymectomy in Myasthenia Gravis Patients

“…The surgical outcomes were analyzed based on the Osserman staging of the patients. The majority of patients who achieved full clinical remission were classified under Osserman stages I, IIA, and III, Table (6). In terms of the relationship between prognostic factors and complete clinical remission, it is noteworthy that out of the patients who achieved complete clinical remission, 21 were females and 14 were males.…”

“…Age, disease duration, intensity of MG symptoms, presence of thymoma, and specific autoantibody profiles may be among these factors. Understanding these prognostic indicators can assist doctors in making informed decisions regarding the surgical therapy of MG, which may result in improved patient outcomes and personalized treatment regimens (6) . Therefore, the purpose of this study was to evaluate the results of thymectomy for MG patients, quantify the degree of clinical improvement after thymectomy by evaluating changes in stage and medication requirement, and identify prognostic factors that may be helpful in determining the best patient selection.…”