Thymectomy by partial sternotomy for the treatment of myasthenia gravis.
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.
Department of Thoracic Surgery, Heart Institute, University of São Paulo, SP, Brazil. paulopego@incor.usp.br
Paulo M
PM
Pêgo-Fernandes
José Ribas Milanez
JR
de Campos
Fabio Biscegli
FB
Jatene
Paulo
P
Marchiori
Francisco Vargas
FV
Suso
Sérgio Almeida
SA
de Oliveira
D000328:Adult; D006801:Humans; D009157:Myasthenia Gravis / Q000401:mortality / Q000601:surgery*; D013249:Sternum / Q000601:surgery*; D013934:Thymectomy / Q000379:methods*