Original ArticlesLong-Term Clinical Outcome After Transcervical Thymectomy for Myasthenia Gravis
Section snippets
Material and methods
We reviewed the clinical outcomes of 52 patients who had transcervical thymectomy for generalized MG without thymoma at The Toronto Hospital between 1977 and 1986. The 52 patients, all of whom returned for follow-up, were included in this review. Patients with thymoma demonstrated radiographically underwent transsternal thymectomy and were excluded from this series.
All patients underwent evaluation at The Toronto Hospital Neuromuscular Clinic by one of us who is a neurologist specializing in
Results
The study population consisted of 52 patients, 15 male and 37 female. Age ranged from 14 to 50 years with a mean age of 28.4 years. The mean follow-up period after thymectomy was 8.4 ± 6.1 years (± the standard deviation). The preoperative mean Osserman grade was 2.7 and the mean Osserman grade at last follow-up, 0.4. None of the patients sustained phrenic nerve injuries or other major surgical morbidity.
The improvement rate (at least one grade) was 90.4%, with palliation (minimal or no
Comment
Our series reports the long-term clinical outcome in patients with generalized MG without thymoma who underwent transcervical thymectomy. Our trial was not a prospective, randomized trial of transcervical versus transsternal thymectomy with blinded clinical assessments, which would have been more definitive. Lacking such a trial, we compared our results with those in previously published series reporting outcomes after differing surgical approaches and found similar complete remission rates.
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