Bookshelf ID: NBK564302
Thymectomy is the resection of the thymus gland. This anterior mediastinal organ can enlarge as in myasthenia gravis and thymoma and harbor malignant cells such as in thymic carcinoma or neuroendocrine tumors. The first thymectomies were performed incidentally in conjunction with thyroidectomies for Grave disease by Garre and Sauerbruch, but it was not until Blalock and colleagues that multiple series were performed with adequate results.
This also included patients with myasthenia gravis but without thymomas. The gold standard approach for thymectomy is a median sternotomy or transsternal approach, but this has evolved to less invasive techniques such as upper partial sternotomy, transcervical, video-assisted thoracoscopic thymectomy, and robot-assisted approaches. Preoperative evaluation should include the functional status and pulmonary function tests, especially with single-lung ventilation in thoracoscopic approaches. Video-assisted and robot-assisted thoracoscopic thymectomies have shown to be superior to the traditional open approaches (transsternal or transcervical) in promoting shorter hospital length of stay and decreased morbidity and mortality.
Bennett B, Rentea RM. Thymectomy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; Jan, 2021.