What is thymectomy surgery?

A thymectomy is a surgical procedure to remove the thymus gland and associated tumors in the upper and front parts of the chest. This procedure is performed to treat conditions such as myasthenia gravis and thymus tumors, whether the tumors are benign or malignant.

Reasons for a thymectomy surgery

This procedure is performed to treat several diseases, including:

Myasthenia gravis: Surgical resection can reduce symptoms and improve health.
Tumors of the thymus gland: Such as a thymoma or thymic carcinoma.
Neuroendocrine tumors: These are rare glandular tumors that can affect the thymus gland.

How to perform a thymectomy surgery

There are two main ways to perform this procedure:

Open surgery (resection through the sternum): The sternum is partially or completely incised to remove the thymus and is often used for tumors larger than 5 cm in diameter.
Minimally invasive method: This includes both robotic surgery or surgery using VATS (video-assisted thoracoscopic surgery).

How to prepare for thymectomy surgery

Before the surgery, the doctor will perform some tests such as:

Rarely, a biopsy is taken in some cases.
Electrocardiogram (EKG).
Computed tomography (CT) or magnetic resonance imaging (MRI).
Positron emission tomography (PET).

In addition, myasthenia gravis patients may require special preoperative preparation such as plasma exchange or intravenous immunoglobulin.

How is thymectomy surgery performed?

First, general anesthesia is administered to the patient.
The patient is intubated, and the lung through which the surgery will be performed is isolated
The surgeon removes the thymus gland using the appropriate technique,e depending on the patient’s condition.
Sometimes, drainage tubes or a blaster are placed after the procedure.
The wound is closed using stitches or staples.

Benefits of thymectomy surgery

This procedure brings many benefits, most notably:

Reduce the symptoms of myasthenia gravis.
Minimize the need for medications such as corticosteroids or immunosuppressants.
Achieve a period of temporary remission or full recovery depending on each patient’s condition.
The treatment of tumors and the possibility of full recovery, especially in early-stage tumors.

Risks or possible complications of thymectomy

As with any surgery and although rare, thymectomy may be associated with some complications, such as:

Injury to large blood vessels, heart, or nerves.
Pneumothorax (atelectasis) or hemothorax.
Rarely the stress of surgery can lead to a debilitating crisis in people with myasthenia gravis.
Pneumonia.

Recovery period after thymectomy surgery

The patient stays in the hospital for at least one night.
The pain is mild and can be relieved with painkillers.
Most patients return to their routine in two to four weeks.

When can I return to work?

How long it takes to return to work or study depends on the type of work and how well the patient has recovered. Patients who are fatigued or do strenuous physical work may need a longer period before returning to daily activities.

Success rate and post-op expectations

70% of patients with myasthenia gravis experience improvement in symptoms and reduced need for medication.

30% to 40% may reach full remission of symptoms.

There is a 1/3 rule in the treatment of myasthenia gravis with thymectomy in which one-third improves completely, one-third improves partially, and there is no improvement in the remaining one-third

In the case of tumors, the cure rate varies depending on the stage of the disease:

First stage: More than 95% cure rate.

Second stage: 75% to 80% complete remission with possible need for radiation therapy.

Third stage: 25% to 40% complete remission with the need for chemotherapy and radiation.

When should I consult a doctor after the procedure?

The doctor should be contacted in the following cases after surgery:

Shortness of breath.
Chest pain.
Rapid heartbeat or breathing.
High temperature.
Bleeding from the wound site.
Deterioration of myasthenia gravis symptoms.

Abstract

Thymectomy surgery is an effective treatment option for certain cases of myasthenia gravis and thymic tumors, offering high success rates. The surgical techniques for thymectomy surgery can vary, with options including open surgery and minimally invasive methods. The best approach is determined based on the patient’s condition and the size of the mass. Patients are advised to maintain constant communication with their doctors to monitor progress and avoid any potential complications. For more information or to schedule a consultation, contact us at Bimaristan Medical Center.