Thymectomy in Myasthenia Gravis

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Abstract
EXPERIENCE WITH THYMECTOMY for myasthenia gravis at Massachusetts General Hospital was fully described in 1960.1Since then, several changes have been made in our postoperative regimen. As a result, patients have shown a smoother and more comfortable postoperative course and mortality has been reduced. Therefore, the changes in postoperative care are worthy of record and will serve as an extension to the book. Thymectomy for myasthenia gravis has incurred a postoperative mortality of 7% to 10% during the past 15 years. In our experience, most of the complications and deaths have resulted from pulmonary complications which usually occur acutely during the first two to three days after operation. This has been manifest by copious upper respiratory secretions and weakness and inability to clear the airway, followed by inadequate gas exchange, atelectasis, and hypoxia. If untreated or compounded by intractable bronchospasm, this sequence of events has proved fatal. We feel

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