Our strategy in the therapy of myasthenia gravis

Surgical treatment of myasthenia gravis has at the V Department of Surgery, V Medicine Faculty of Charles University in Prague a multiyear tradition which has originated in the 60's of the 20(th) century. Since that time we carried out over 1000 operations on the thymus, especially thymectomy for myasthenia gravis (MG) and with lesser frequency for thymomas. Thymectomy combined with exenteration of fatty tissue from the front mediastinum belongs to basic MG surgery. According to our experience an optimal approach to the thymus is given by partial sternotomy. A jugular approach is not regarded as enough radical. Videothoracoscopic approach and operation are possible but take more time, however they are the method of choice at some workplaces. The combined conservative and surgical treatment brings in 80% of the cases an obvious improvement or deletion of the symptoms of the disease.