THYMECTOMY FOR MYASTHENIA AND THYMOMA: PESHAWAR EXPERIENCE OF 63 CASES

Objective: To determine the safety and efficacy of thymectomy is thymomas and myasthenia gravis.Material and Methods: A prospective observational study was carried out at Cardiothoracic Surgery unit Lady Reading Hospital Peshawar from March 1997 to April 2000. A total of 63 patients with a male and female ratio of 23:40, age range 15-50 years (Mean age 30.5 years) were entered into the study. Thirty nine presented with myasthenia while 24 presented with a mediastinal mass. They all underwent thymectomy via median sternotomy.Results: There was one mortality due to failure to come off the ventilator in grade lie. Myasthenia with a malignant thymoma, who was ventilated for 9 days. Out of 39 myasthenias 21 were off medication at 18 months followup, 13 were on reduced medication while 5 continued on the same medication. All thymomas without myasthenia did not need any medication.Conclusion: Thymectomy in a thoracic surgical unit, with ventilatory backup, is a safe and effective treatment for both myesthenias and non myasthenics with thymomas, and stops the progress of an other wise crippling and fatal disease.