Thymectomy in myasthenia gravis

Myasthenia gravis is a rare autoimmune neuromuscular disease characterized by the production of autoantibodies to acetylcholine receptors or to functionally related proteins on the postsynaptic membrane of the neuromuscular junction. Most patients are diagnosed with thymus diseases such as follicular hyperplasia and thymoma, contributing to the pathogenesis of myasthenia gravis. Thymectomy is a pathogenetically justified surgical treatment for myasthenia gravis. The results of studies of the effect of thymectomy on the clinical course of seropositive nonthymomatous myasthenia gravis, seronegative myasthenia gravis, and myasthenia associated with thymoma are presented. The goal of surgical treatment is to achieve complete stable or pharmacologic remission, or also to reduce the dose of previously taken immunosuppressors and corticosteroids, while improving patients’ quality of life. Minimally invasive approaches, such as video or robotics, are preferred, as they facilitate faster recovery, shorter hospitalization and better cosmetic results, while ensuring that the efficacy of thymectomy is comparable to that of transternal access.