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Long-term outcome and quality of life after thymectomy for myasthenia gravis
C Busch1, A Machens, U Pichlmeier
1Department of Surgery, University of Hamburg, Germany.
Objective:
The authors identify criteria suitable to predict long-term clinical improvement and evaluate quality of life after thymectomy for myasthenia.
Design:
Retrospective analysis with long-term follow-up (mean 92 months) was conducted for 86 patients and questionnaire interviews were performed for 65 patients who underwent thymectomy between 1976 and 1993.
Main Outcome Measures:
The authors used the Osserman Score and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire.
Results:
After thymectomy, lasting benefits were achieved predominantly by patients with moderate and severe myasthenia, and this association was significant (p < 0.001) in both bivariable and multiple analyses. No correlation was observed between outcome and thymic pathology, patient age or gender, duration of disease, preoperative plasmapheresis, and medication. Restitution to normal was complete at most recent follow-up as to physical status, working ability, and cognitive and social functions, but some emotional and vegetative deficits remained.
Conclusion:
Future patient selection for thymectomy should-apart from those with suspected thymoma-concentrate on patients with moderate and severe myasthenia unresponsive to conservative management.