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The thymectomy is an operation in which the thymus gland is removed. This procedure is most commonly carried out as a treatment for an autoimmune disorder called myasthenia gravis. Treating this disorder with a thymectomy can induce remission, but remission is not always permanent.
Myasthenia gravis is a disease of the immune system which causes weakness in skeletal muscles. This disease is caused by abnormal thymus behavior that causes immune cells to react to proteins in muscle tissue, causing muscle damage and weakness. Because the thymus gland is involved in regulating the immune system, removal of the thymus can be a useful treatment for the disorder. The thymectomy procedure does not severely weaken the adult immune system because its most important role, that of priming T cells to respond to disease, is completed before adolescence.
Prior to undergoing thymectomy surgery, patients must undergo a variety of tests to ensure they are physically strong enough to withstand the strain of the procedure. This is important because myasthenia gravis can severely weaken the body. Patients will undergo x-rays, blood and urine tests, breathing tests, and muscle strength tests. They may also be required to follow a special diet, and avoid some types of medication, for several days before surgery.
The surgery can be carried out in three different ways. In the transsternal form of the procedure, an incision is made right over the sternum. The sternum bones are then separated so that the thymus gland can be removed. In the transcervical operation, the incision is made above the sternum. This is a less invasive approach, as only a small incision in the neck is necessary to remove the thymus gland.
Even less invasive is a video-assisted thoracic surgery procedure. These require only a few very small incisions, through which surgical tools and a mini-camera are inserted. Through the camera, the operation site is projected onto a screen, to allow the surgeon to view it easily.
The procedure takes around two to three hours, and is carried out under general anesthetic. Once the procedure is completed, most patients will have a hospital stay of between one and three days. Time for complete recovery varies from several weeks to around three months. The time taken depends on the overall physical health of the patient, and the type of procedure which was used to remove the thymus.
Possible thymectomy complications include respiratory failure during or in the first few days or weeks after the procedure, which is a risk mostly for older men and women. There is also a risk of infection at the wound site, and a very small risk of nerve damage during the operation. Any symptoms of infection, such as chills, fever, swelling, redness, or pain at the infection site should get prompt medical attention. Symptoms of respiratory problems, such as difficulty breathing, should also be treated promptly.
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