[The value of thymectomy in myasthenia gravis]

In the management of Myastenia gravis thymectomy has gained an important position. Still in discussion is whether a transsternal approach gives a superior result to a collar approach. Between 1970 and 1986 35 patients with Myasthenia gravis underwent thymectomy, in 12 by a collar approach, in 19 by sternotomy and 4 by thoracotomy. Results were equivalent independent of the approach but only after transsternal incision complications occurred in 3 patients. At 6 months after operation 18 of 35 patients were classified in a lower category following Ossermann's classification, an other 12 were stable and in 5 the information unobtainable. At the end of follow-up between 1 and 17 years, 19 out of 29 were improved; 4 unchanged and 5 demonstrated progressive disease, 1 patient died due to the disease. Almost 70% of patients judged the operation as helpful. We conclude that the collar approach is safe and effective in patient without thymoma and that in our department thymectomy has an important place in the treatment of Myasthenia gravis.