[Surgical aspects in the treatment of myasthenia gravis]

We treated 81 patients suffering from myasthenia with thymectomy in a 10-year period (1991-2000). We think, that thymectomy must be carried out in the treatment of myasthenia gravis, unless contraindications are present. The operation is not urgent and in the preoperative period patients must reach optimal condition with the help of standard medical treatment. The result of the operation is influenced by the length of time between the beginning of the complaints and the operation. The best results can be expected when the operation is performed in less than 2 years time, however an operation performed later may also be successful. We operated on 63% (n = 51) of the patients between 4-12 months, on 18% (n = 15) between 13-24 months and on 18.6% (n = 15) more than 25 months after the beginning of the complaints. Complete thymectomy was performed in all patients through median sternotomy. We had no operative mortality. Our postoperative results were evaluated with Jaretzki classification: 75% of our patients are in remission and asymptomatic (n = 61).