MG and thymectomy

Q: Thymectomy should be performed even in non-thymomatous myasthenia gravis (MG)? ( select one)

A) True
B) False


Answer: A

The famous multi-center MGTX trial, published in 2016 has pretty much resolved the above controversy. 126 patients were randomized between extended transsternal thymectomy plus alternate-day prednisone, and alternate-day prednisone alone. 

The former group did better over three years with the time-weighted average Quantitative Myasthenia Gravis score. Also, the average requirement for alternate-day prednisone and hospitalization for MG exacerbations was lower thymectomy group over three years. 

#surgical-critical-care


References:

 Wolfe GI, Kaminski HJ, Aban IB, et al. Randomized Trial of Thymectomy in Myasthenia Gravis. N Engl J Med 2016; 375:511.