THYMECTOMY FOR MYASTHENIA GRAVIS: PESHAWAR EXPERIENCE OF 27 CASES IN FIVE YEARS

Objective: To determine the safety and efficacy of Thymectomy for myasthenia gravis.Material and Methods: This observational descriptive study was conducted at Departments of Cardiothoracic Surgery and Neurology Lady Reading Hospital Peshawar from January2002 to December 2006. Computerized clinical data of27 diagnosed cases ofmyasthenia gravis that underwent thymectomy were retrospectively analyzed. Patients who were unfit for surgery were excluded from the study. CTscan was done in all patients apart from routine investigations. Preoperative medication included anticholinesterase drug They all underwent Thymectomy via median sternotomy.Results: A total of27 patients (09males and18 females) with a mean age of30.5years (range 15-50 years) were analyzed. The preoperative duration of the disease ranged from 0.5 to 120 months (mean=25.72 +/- 30.68 months). According to the Myasthenia Gravis Foundation of America (MGFA) clinical classification, 20 (74.07%o)patients were in stage II while 7 (25.925%)patients were in stage III.The histology ofthymus glands consisted ofhyperplasia in 12 (44.4%) patients, normal in 10 (37.1%), atrophic thymus in 3 (11.1%) and thymoma in 2 (7.4%) patients. Hospital mortality was 7.4%> (n=2/27) while morbidity was 3.7% (n=1/27). The mean follow upperiod was 31.5 months (3-63 months). Complete remission was achieved in 55.55% (n=15/27) patients, and marked improvement in 25.92%> (n=7/27), for a total benefit rate of80% Five (18.51%>) patients remained unchanged and had no clinical improvement.Conclusion: Thymectomy is a sale and effective treatment for patients with myasthenia gravis.