[Trans-sternal thymectomy in myasthenia gravis and thymoma]

In a retrospective study the role of thymectomy in the treatment of myasthenia gravis (n = 19) and of thymoma (n = 7) was analysed in 26 patients operated on between 1989 and 1994 in the Department of Surgery at the University of Cologne. The mean follow-up period was 28 months (follow-up rate: 96.2%). A transsternal incision was preferred in 24 cases (92.3%). Patients with myasthenia gravis were preoperatively classified according to Ossermann. Patients with thymoma were classified according to Masaoka. 17 patients (89.5%) with myasthenia gravis demonstrated a significant improvement. 4 patients (57.1%) with thymoma were free of recurrence. Stage II to IV thymoma should receive postoperative radiotherapy. Patients with stage IV lesions are usually offered postoperative radiation therapy plus cis-platinum based chemotherapy.