ABSTRACT
The presence of myasthenia gravis (MG) constitutes the most common indication for the performance of elective thymectomy. With the development and refinement of minimally invasive approaches to thymectomy, the risk-benefit ratio seems to be tilted toward the performance of thymectomy, even in the older patient or those with minimal symptoms. Specific preoperative testing prior to thymectomy is limited to computed tomography (CT) scanning of the chest and measurement of pulmonary function. The CT scan of the chest is used to assess for the presence of a thymoma, a finding that could dictate the operative approach. Prior to thymectomy, patients should be managed with optimal medical therapy following establishment of the specific diagnosis of MG. General anesthesia can be performed safely in patients with MG following optimal preparation and adequate monitoring of neuromuscular transmission during and following the surgical procedure. The standard operation for thymectomy in patients with MG consists of a median sternotomy with total removal of all thymic tissue.
