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Abstract
We reviewed the long-term clinical outcome after transcervical thymectomy for generalized
myasthenia gravis without thymoma in 52 patients who had this procedure at The Toronto
Hospital between 1977 and 1986, and compared the results with those reported after
more radical surgical approaches.
Preoperative and postoperative patient evaluations were based on a modified Osserman
classification. We defined complete remission as asymptomatic with normal strength
and without medications for myasthenia gravis. The complete remission rate was selected
as the best measure for comparison between different surgical approaches.
The 52 patients were followed up for a mean of 8.4 years (+/-6.1 years [standard deviation]).
The preoperative mean Osserman grade was 2.7 compared with 0.4 at final follow-up.
Complete remission occurred in 44.2% of patients. Similar results are reported after
transsternal thymectomy.
Comparable results after transcervical and transsternal thymectomy favor the use of
the less radical approach.