Surgical Treatment Of Myasthenia Gravis Associated With Thymoma

Objective:To summarize the therapcutic effect of surgical management, the perioperative treatment and prognosis of myasthenia gravis with thymoma. Methods:The data of 36 cases of myasthenia gravis with thymoma were treated by surgical operation from January 1995 to October 2009 were analyzed retrospectively. Complete follow-up data was collected. The result of operation was classified into 4 grades: remission, improvement, no change, and deterioration. The data was analyzed by proper statistic method. Results:No patient died through the operation.6 cases suffered from crisis of myasthenia gravis at carlierperiod after operation and were cured successfully. 1case dies of respiratory failure because she refuse incision of trached after crisis of myasthenia gravis happened.2 cases who appeared pulmonary infection after operation were cured.36 cases were followed up. Complete remission of MG was achieved in 18 cases, partial remission was seen in 11 cases, no change was got in 6 cases, deterioration was happened in 1 cases. Effective rate(80.6%). A strong correlation was noted between the clinical stage and remission rate after operation(P<0.01). Conclusions:Thymectomy is effective in most myasthenia gravis patients. An early operation is indicated, shorter duration of symptoms is related to better outcomes. Chest CT can increase the accuracy early diagnosis of thymoma. perioperative manegment is very important to avoid crisis of myasthenia gravis. An intimate relation was noted invasive extent of thymoma and prognosis of thymoma associated with gravis myasthenia gravis.