title: Thymectomy is more effective than conservative treatment for myasthenia gravis regarding outcome and clinical improvement.
abstract: BACKGROUND
  Myasthenia gravis (MG) is an autoimmune disease with a tremendous impact on the quality of life. Controversies over which patients should be operated on because they may benefit most from thymectomy are still ongoing. The aim of this study was to report our long-term results of patients with MG with comparison of thymectomy and conservative treatment.
  
  
  METHODS
  We report a series of 252 patients with MG. Survival data were generated. Patients were seen in the outpatient clinic, where a modified Osserman score and quality of life score were evaluated at the end of the follow-up period for all surviving patients.
  
  
  RESULTS
  A total of 172 patients with MG were followed after thymectomy or with conservative treatment for a median time of 9.8 years. Patients who underwent thymectomy had significantly greater rates of remission and improvement compared with conservative treatment. Furthermore, they had a significantly greater survival.
  
  
  CONCLUSIONS
  Currently, different effective modalities of treatment are available in patients with MG. In our long-term follow-up, thymectomy was superior to conservative treatment regarding overall survival, clinical improvement, and remission rate. Therefore, thymectomy should be considered strongly for all patients with generalized MG.
authors.affiliation: Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Germany. k.bachmann@uke.uni-hamburg.de
authors.forename: Kai
authors.initials: K
authors.lastname: Bachmann
authors.forename: Doreen
authors.initials: D
authors.lastname: Burkhardt
authors.forename: Inken
authors.initials: I
authors.lastname: Schreiter
authors.forename: Jussuf
authors.initials: J
authors.lastname: Kaifi
authors.forename: Paulus
authors.initials: P
authors.lastname: Schurr
authors.forename: Christoph
authors.initials: C
authors.lastname: Busch
authors.forename: Gunther
authors.initials: G
authors.lastname: Thayssen
authors.forename: Jakob R
authors.initials: JR
authors.lastname: Izbicki
authors.forename: Tim
authors.initials: T
authors.lastname: Strate
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D013934:Thymectomy; D016896:Treatment Outcome; D055815:Young Adult