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Ann Thorac Surg 2002;74:204-208
© 2002 The Society of Thoracic Surgeons

Original article: general thoracic

Thymectomy by partial sternotomy for the treatment of myasthenia gravis

Paulo M. Pêgo-Fernandes, MD, PhD*a, José Ribas Milanez de Campos, MD, PhDa, Fabio Biscegli Jatene, MD, PhDa, Paulo Marchiori, MD, PhDb, Francisco Vargas Suso, MD, PhDc, Sérgio Almeida de Oliveira, MD, PhDa

a Department of Thoracic Surgery, Heart Institute, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
b Department of Neurology, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
c Department of Pneumology, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil

Accepted for publication March 25, 2002.

* Address reprint requests to Dr Pêgo-Fernandes, Heart Institute, HC-FMUSP, Division of Surgery, Av Dr Enéas Carvalho de Aguiar, 44, CEP 05403-000 São Paulo, SP, Brazil
e-mail: paulopego{at}incor.usp.br

Background. Myasthenia gravis is an autoimmune disease characterized by weakness and fatigue of voluntary muscles. Surgical treatment of choice for myasthenia gravis has been thymectomy. However, thymectomy indications and surgical approach are still controversial. The purpose of this study is to evaluate the efficacy of partial median sternotomy approach to the thymus.

Methods. From 1973 to 1999, 478 patients with myasthenia gravis underwent thymectomy through a partial median sternotomy.

Results. Sixty-one patients (12.7%) had complete remission of symptoms, 299 (62.5%) had a significant improvement, and 83 (17.4%), a mild improvement; whereas 35 patients (7.4%) had no improvement of clinical symptoms.

Conclusions. Partial median sternotomy has shown to be a useful surgical approach to the thymus, as demonstrated by the good functional and aesthetic results, associated with low morbidity and no mortality.




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