Evolution of the indications and results of treatment of myasthenia by thymectomy.

Four-hundred and fifty thymectomies from myasthenia were carried out at the Marie Lannelongue Surgical Center up to October 1980. This report deals with 248 patients who were operated on up to October 1977 and who were followed up for periods of 18 months to over 20 years with a view to examining the indications and results of thymectomy. In our opinion patients with thymomas should be operated upon when their general and cardiorespiratory condition allows surgery, and if there is no tumoral spread which precludes eradication. In the latter cases, irradiation and antimitotics are the only remaining resources. In 82% of the 248 patients who had a long term follow-up, results were good. In the group of patients obliged to continue regular medical treatment, thymectomy prevents deterioration, allows the patient to be administered better medical treatment, and to return to normal activity. Moreover, by reducing the risk of a tumor developing (75% of the cases), complementary irradiation treatment is avoided.