Last updated
ICD-9-CM 07.8
MeSH D013934

A thymectomy is an operation to remove the thymus. It usually results in remission of myasthenia gravis with the help of medication including steroids. However, this remission may not be permanent. Thymectomy is indicated when thymoma are present in the thymus. Anecdotal evidence suggests MG patients with no evidence of thymoma may still benefit from thymectomy, thus the procedure is (unless and until a much-discussed clinical survey ever reaches a contradictory conclusion) commonly prescribed.


Surgical approaches

There are a number of surgical approaches to the removal of the thymus gland: transternal (through the breast bone), transcervical (through a small neck incision), transthoracic (through one or both sides of the chest.)[ citation needed ]

There has been no difference in success in symptom improvement between the transsternal approach and the minimally invasive transcervical approach. [1]

Video-assisted approaches, such as thoracoscopic surgery, are increasingly prescribed since the less invasive nature of the procedure strikes a balance with the lack of actual clinical evidence supporting thymectomy in non-thymomal cases. [2]

Impact of thymic loss

Thymectomy is a treatment for myasthenia gravis, a neuromuscular disease. [3] For about 60% of people with myasthenia gravis, thymectomy significantly improves their symptoms of muscle weakness. In about 30% of cases, thymectomy results in permanent remission of myasthenia gravis, negating the need for any additional medication. Improvements in condition as a result of thymectomy are often delayed, typically occurring one or two years after the surgical procedure, though could be as late as five years. In some people, thymectomy does not alleviate any symptoms of myasthenia gravis. [4]

Experiments involving thymectomy in newborn mice showed that it unexpectedly resulted in wasting disease when performed before the mouse was three days old. This is because the thymus is the site where T cells are generated. Removal of the thymus resulted in autoimmunity, in which the immune cells attack the organism's own healthy cells and tissues. [5]

Those who have had their thymus removed should not receive the Yellow Fever vaccine. [6] [7]

See also

Related Research Articles

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Myasthenia gravis Autoimmune disease resulting in skeletal muscle weakness

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  2. Ng CS, Wan IY, Yim AP (June 2010). "Video-assisted thoracic surgery thymectomy: the better approach". The Annals of Thoracic Surgery. 89 (6): S2135-41. doi:10.1016/j.athoracsur.2010.02.112. PMID   20493997.
  3. "Thymectomy for Myasthenia Gravis". Cleveland Clinic. 14 May 2019. Retrieved 14 September 2020.
  4. "Thymectomy information". Myaware. Retrieved 14 September 2020.
  5. Plitas G, Rudensky AY (2020-03-09). "Regulatory T Cells in Cancer". Annual Review of Cancer Biology. 4 (1): 459–477. doi: 10.1146/annurev-cancerbio-030419-033428 .
  6. "Vaccination-Yellow fever". NHS. 23 October 2017. Retrieved 4 March 2021.{{cite web}}: CS1 maint: url-status (link)
  7. Eidex, Rachel Barwick (2004-09-11). "History of thymoma and yellow fever vaccination". The Lancet. 364 (9438): 936. doi:10.1016/S0140-6736(04)17017-7. ISSN   0140-6736. PMID   15364184. S2CID   54408259.