Thymectomy (removal of the thymus/bris) can have a positive effect on the course of the disease. In young patients, this may result in a decrease in symptoms. Then, even discontinuation of immunosuppressive drugs is possible.
- Indications:
- Patients with generalized (affecting the entire body) myasthenia without thymoma.
- Patients between 15-50 years of age, insofar as thymectomy is performed within the first two years after diagnosis
- Advantage:
- Very low perioperative mortality (mortality during surgery).
- Disadvantage:
- Success often only recognizable after several years, accordingly questionable as a causal therapeutic measure
- Unsuitable for:
- Children and adolescents between 5 and 10 years of age – the procedure should only be considered after poor response to cholinesterase inhibitors, as adverse effects on the immune system are possible
- Patients without detectable autoantibodies to acetylcholine receptors (anti-AChR-AK).
- Patients with autoantibodies against muscle-specific tyrosine kinase (anti-MuSK-AK).
Notice: In the context of thymectomy, a change to aspiration-avoiding diet, preventive swallowing therapy and, in very severe courses, a food administration via a gastric tube (PEG tube; percutaneous endoscopic gastrostomy: endoscopically created artificial access from the outside through the abdominal wall into the stomach), a device suction of the secretion and / or a tracheostoma (tracheotomy) may be required.
