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Reoperation after transcervical thymectomy for myasthenia gravis

Second Department of Surgery, Nagoya City University Medical School (Dr. Masaoka), Nagoya, and the First Department of Surgery, Osaka University Medical School (Drs. Monden, Seike, Tanioka, and Kagotani), Osaka, Japan.

Among 137 thymectomized patients with nonthy-momatous myasthenia gravis (MG), six were reoperations. Thymectomy had initially been performed by the transcervical approach, but was ineffective. Extended thymectomy was then performed by median sternotomy. The reoperations revealed residual thymus (average weight, 19 gm) in all cases.

Postoperative courses were favorable in three patients and unfavorable in three others. The latter had received high-dose steroid therapy before the second operation. We conclude that total thymectomy by the transcervical approach is almost impossible, and that reoperation may accelerate improvement in some cases.

Address correspondence and reprint requests to Dr. Masaoka, Nagoya City University Medical School, The Second Department of Surgery, Kawasumi 1. Mizuho-cho, Mizuho-ku, Nagoya, 467 Japan.

Accepted for publication June 17, 1981.

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