# Thymectomy

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Surgical removal of the thymus

Medical intervention

Thymectomy ICD-9-CM 07.8 MeSH D013934 [edit on Wikidata]

A **thymectomy** is an operation to remove the [thymus](/source/Thymus). It usually results in remission of [myasthenia gravis](/source/Myasthenia_gravis) with the help of medication including [steroids](/source/Steroids). However, this remission may not be permanent. Thymectomy is indicated when [thymoma](/source/Thymoma) are present in the thymus. Anecdotal evidence suggests MG patients with no evidence of thymoma may still benefit from thymectomy.[1]

## Surgical approaches

There are a number of surgical approaches to the removal of the thymus gland: transternal (through the [breast bone](/source/Sternum)), transcervical (through a small neck incision), and transthoracic (through one or both sides of the chest).[2]

- The transternal approach is most common and uses the same length-wise incision through the sternum (breast bone) used for most open-heart surgery. It is espoused by surgeons such as Alfred Jaretzki and is the most commonly performed procedure due to its relative simplicity.

- The transcervical approach is a less invasive procedure that allows for removal of the entire thymus gland through a small neck incision.

There has been no difference in success in symptom improvement between the transsternal approach and the minimally invasive transcervical approach.[3]

Video-assisted approaches, such as [thoracoscopic surgery](https://en.wikipedia.org/w/index.php?title=Thoracoscopic_surgery&action=edit&redlink=1), are increasingly prescribed since the less invasive nature of the procedure strikes a balance with the lack of actual clinical evidence supporting thymectomy in non-thymomal cases.[4]

## Impact of thymic loss

Thymectomy is a treatment for [myasthenia gravis](/source/Myasthenia_gravis), a neuromuscular disease.[5] For about 60% of people with myasthenia gravis, thymectomy significantly improves their symptoms of muscle weakness. In about 30% of cases, thymectomy results in permanent remission of myasthenia gravis, negating the need for any additional medication. Improvements in condition as a result of thymectomy are often delayed, typically occurring one or two years after the surgical procedure, though could be as late as five years. In some people, thymectomy does not alleviate any symptoms of myasthenia gravis.[6]

Experiments involving thymectomy in newborn mice showed that it unexpectedly resulted in wasting disease when performed before the mouse was three days old. This is because the thymus is the site where [T cells](/source/T_cell) are generated. Removal of the thymus resulted in [autoimmunity](/source/Autoimmunity), in which the immune cells attack the organism's own healthy cells and tissues.[7]

Those who have had their thymus removed should not receive the Yellow Fever vaccine.[8][9]

## See also

- [List of surgeries by type](/source/List_of_surgeries_by_type)

## References

[Scholia](https://www.wikidata.org/wiki/Wikidata:Scholia) has a *topic* profile for ***[Thymectomy](https://iw.toolforge.org/scholia/topic/Q3090790)***.

1. **[^](#cite_ref-1)** Cea, Gabriel; Benatar, Michael; Verdugo, Renato J; Salinas, Rodrigo A (2013-10-14). Cochrane Neuromuscular Group (ed.). ["Thymectomy for non-thymomatous myasthenia gravis"](https://doi.wiley.com/10.1002/14651858.CD008111.pub2). *Cochrane Database of Systematic Reviews* (10) CD008111. [doi](/source/Doi_(identifier)):[10.1002/14651858.CD008111.pub2](https://doi.org/10.1002%2F14651858.CD008111.pub2). [PMC](/source/PMC_(identifier)) [12083877](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083877). [PMID](/source/PMID_(identifier)) [24122674](https://pubmed.ncbi.nlm.nih.gov/24122674).

1. **[^](#cite_ref-2)** ["Thoracic Surgery – Information for patients: Having a thymectomy procedure"](https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/thoracic-surgery-information-patients-having-thymectomy-procedure). *University College London Hospitals NHS Foundation Trust*. Retrieved 2024-09-19.

1. **[^](#cite_ref-Calhoun_1999_3-0)** Calhoun RF, Ritter JH, Guthrie TJ, Pestronk A, Meyers BF, Patterson GA, et al. (October 1999). ["Results of transcervical thymectomy for myasthenia gravis in 100 consecutive patients"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420904). *Annals of Surgery*. **230** (4): 555–9, discussion 559–61. [doi](/source/Doi_(identifier)):[10.1097/00000658-199910000-00011](https://doi.org/10.1097%2F00000658-199910000-00011). [PMC](/source/PMC_(identifier)) [1420904](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420904). [PMID](/source/PMID_(identifier)) [10522725](https://pubmed.ncbi.nlm.nih.gov/10522725).

1. **[^](#cite_ref-4)** Ng CS, Wan IY, Yim AP (June 2010). ["Video-assisted thoracic surgery thymectomy: the better approach"](https://doi.org/10.1016%2Fj.athoracsur.2010.02.112). *The Annals of Thoracic Surgery*. **89** (6): S2135-41. [doi](/source/Doi_(identifier)):[10.1016/j.athoracsur.2010.02.112](https://doi.org/10.1016%2Fj.athoracsur.2010.02.112). [PMID](/source/PMID_(identifier)) [20493997](https://pubmed.ncbi.nlm.nih.gov/20493997).

1. **[^](#cite_ref-5)** ["Thymectomy for Myasthenia Gravis"](https://my.clevelandclinic.org/health/treatments/17555-thymectomy-for-myasthenia-gravis). *Cleveland Clinic*. 14 May 2019. Retrieved 14 September 2020.

1. **[^](#cite_ref-6)** ["Thymectomy information"](https://www.myaware.org/thymectomy-information-sheet). *Myaware*. 4 March 2020. Retrieved 14 September 2020.

1. **[^](#cite_ref-7)** Plitas G, Rudensky AY (2020-03-09). ["Regulatory T Cells in Cancer"](https://doi.org/10.1146%2Fannurev-cancerbio-030419-033428). *Annual Review of Cancer Biology*. **4** (1): 459–477. [doi](/source/Doi_(identifier)):[10.1146/annurev-cancerbio-030419-033428](https://doi.org/10.1146%2Fannurev-cancerbio-030419-033428).

1. **[^](#cite_ref-8)** ["Vaccination-Yellow fever"](https://www.nhs.uk/conditions/yellow-fever/vaccination). *NHS*. 23 October 2017. Retrieved 4 March 2021.

1. **[^](#cite_ref-9)** Eidex, Rachel Barwick (2004-09-11). ["History of thymoma and yellow fever vaccination"](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17017-7/abstract). *The Lancet*. **364** (9438): 936. [doi](/source/Doi_(identifier)):[10.1016/S0140-6736(04)17017-7](https://doi.org/10.1016%2FS0140-6736%2804%2917017-7). [ISSN](/source/ISSN_(identifier)) [0140-6736](https://search.worldcat.org/issn/0140-6736). [PMID](/source/PMID_(identifier)) [15364184](https://pubmed.ncbi.nlm.nih.gov/15364184). [S2CID](/source/S2CID_(identifier)) [54408259](https://api.semanticscholar.org/CorpusID:54408259).

v t e Procedures relating to the haematopoetic and lymphatic systems Bone marrow Stem cell transplantation Hematopoietic stem cell transplantation Thymus Removal Transplantation Spleen Removal Transplantation Lymph nodes Lymphadenectomy Neck dissection Retroperitoneal lymph node dissection Lymph node biopsy Tonsils see Template:Procedures on the mouth and pharynx Imaging Lymphogram

v t e Test and procedures involving the endocrine system Pancreas Islet cell transplantation see also digestive system procedures Pituitary Hypophysectomy Transsphenoidal surgery Combined rapid anterior pituitary evaluation panel Thyroid Thyroidectomy Parathyroidectomy Tests Radioactive iodine uptake test Sestamibi parathyroid scan TRH stimulation test Adrenal gland Adrenalectomy Tests Dexamethasone suppression test ACTH stimulation test Captopril suppression test Fluid deprivation test Pineal gland Pinealectomy

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Adapted from the Wikipedia article [Thymectomy](https://en.wikipedia.org/wiki/Thymectomy) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Thymectomy?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.