Thymectomy in Myasthenia Gravis: Response, Complications, and Associated Conditions

Results. The majority of patients were women (119 of 152); mean age was 32.10 � 14.42 years, while time elapsed from diagnosis to surgery was 20.67 � 19.7 months. Transsternal thymectomy was performed on 113 patients and transcervical on 39. Forty percent of patients achieved remission and 28% showed improvement; with this, a good response to thymectomy was seen in 68% of patients ( n � 103). The most important variables associated with remission were � 60 years of age, � 2 years of preoperative symptoms, and use of pyridostigmine at low doses. Factors related with poor response were � 60 years of age, preoperative Osserman stage other than II, use of high doses of pyridostigmine, use of corticosteroids, and presence of thymic atrophy or thymoma in histopathologic analyses. There was no mortality, although 20 patients (13%) presented complications. Conclusions. Mexican patients with MG undergoing thymectomies show improvement and remission rates similar to those reported by other studies. Age, length of symptoms, thymic pathology, and medications appear to be predictors of response to thymectomy for MG. © 2002 IMSS. Published by Elsevier Science Inc.