(Removal of the Thymus Gland)En Español (Spanish Version)
A thymectomy is surgery to remove the thymus gland. This gland is located in the upper portion of the chest, behind the sternum (breastbone).
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Reasons for Procedure
The thymus gland helps control immune cell growth. It is usually very active when you are an infant, but its function tapers off as you get older. The thymus acts abnormally when a person has myasthenia gravis. This is a disease characterized by weakness of skeletal muscles of the body. This happens because the body's immune system attacks the area where the nerves attach to the muscles. Thymectomy is used to treat myasthenia gravis.
A thymectomy may also be done if the thymus has a tumor.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a thymectomy, your doctor will review a list of possible complications, which may include:
- Damage to other organs
- Nerve injury
- Respiratory failure
Factors that may increase the risk of complications include:
- Age: 60 years or older
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- X-rays—a test that uses radiation to take a picture of structures inside the body
- Blood tests
- Urine tests
- Muscle strength tests
- Breathing tests
- Follow a special diet, which may include withholding foods and fluids before surgery.
- Take prescribed medicines.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Arrange to have someone drive you to and from the procedure. Ask for help at home after your procedure.
General anesthesia will be given. You will be asleep.
Description of Procedure
There are three common methods:
- Transsternal approach—An incision will be made in the skin over your breastbone. The breastbone will be pulled apart. The thymus gland will then be exposed and removed. The incision will be closed with stitches or staples.
- Transcervical approach—A small incision is made across the lower part of the neck, just above the breastbone. The thymus gland will be removed. The incision will be closed with stitches or staples.
- Video-assisted thoracic surgery (VATS) or robot-assisted thoracic procedures—This is a less invasive option. Several tiny incisions are made in the area. A tiny camera will be inserted through one of the incisions. The camera will send images to a monitor in the room. Robotic arms may be used to do the surgery. Special tools will be passed through the remaining incisions to remove the thymus. After the thymus is removed, the incisions will be closed with stitches.
Immediately After Procedure
You will be taken to a recovery room. There you will be monitored for any complications.
How Long Will It Take?
About 1-3 hours
How Much Will It Hurt?
Anesthesia will block the pain during the surgery. You may feel some pain as the anesthesia wears off. Your doctor will give you medicine to help manage the pain.
Average Hospital Stay
The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications arise.
At the Hospital
You will be given fluids and medicine via an IV line. You will be instructed to practice deep breathing, coughing, and frequent turning. Nurses will measure your muscle strength and breathing ability to determine the effectiveness of the surgery.
The recovery time varies from patient to patient, depending on the surgical approach. It may take as little as 1-2 weeks or as long as three months before you can return to work or school. Ask your doctor about when it is safe to shower, bathe, or soak in water. Be sure to follow your doctor’s instructions.
If the surgery was done for myasthenia gravis:
- Improvement in muscle strength may take several months to a few years.
- It is important to work with a neurologist during the recovery period to regulate medicines.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain that you cannot control with the medicines you have been given
- Cough, difficulty breathing, or chest pain
- Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Pain and/or swelling in your feet, calves, or legs
- Any other worrisome symptoms
In case of an emergency, CALL 911 .
Myasthenia Gravis Foundation of America
National Institute of Neurological Disorders and Stroke
Muscular Dystrophy Canada
General Information about Thymoma and Thymic Cancers. National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/thymoma . Accessed February 13, 2008.
Myasthenia gravis fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/myasthenia_gravis/detail_myasthenia_gravis.htm#84053153 . Accessed February 13, 2008.
Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review). National Guideline Clearinghouse website. Available at: http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=2826&nbr=2052 . Accessed February 13, 2008.
Sabiston Textbook of Surgery. 17th ed. Philadelphia, PA: Saunders; 2004.
Surgical treatment options for myasthenia gravis. University of Maryland Medical Center website. Available at: http://www.umm.edu/mg/surgery.html . Accessed February 13, 2008.
Thymectomy. Myasthenia Gravis Association of Pennsylvania website. Available at: http://www.mgawpa.org/pages/thymectomy.htm . Accessed February 13, 2008.
6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed December 2010 by Bridget Sinnott, MD, FACE
Last updated Updated: 6/3/2011
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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