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Thymectomy

(Removal of the Thymus Gland)

Definition

A thymectomy is surgery to remove the thymus gland. This gland is under the breastbone. It helps the immune system to develop during childhood.

Thymus Gland
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Reasons for Procedure

This surgery is done to treat:

  • Myasthenia gravis—a condition that causes the thymus to act abnormally
  • Thyoma—a tumor in the thymus

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Damage to nearby structures
  • Respiratory failure

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery

Anesthesia

General anesthesia will be used. You will be asleep.

Description of Procedure

The surgery may be done in one of three ways:

  • Trans-sternal approach—An incision will be made in the skin over the breastbone. The breastbone will be pulled apart. The thymus gland will then be removed. The incision will be closed with stitches. A bandage will be placed over the site.
  • Transcervical approach—A small incision is made across the lower neck, just above the breastbone. The thymus gland will be removed. The incision will be closed with stitches. A bandage will be placed over the site.
  • Video-assisted thoracic surgery (VATS) or robot-assisted thoracic procedures —Several tiny incisions are made in the area. A tiny camera will be inserted through one of the incisions. The camera will send images to a nearby monitor. Robotic arms may be used to do the surgery. Special tools will be passed through the remaining incisions. The thymus will be removed. The incisions will be closed with stitches. A bandage will be placed over the site.

How Long Will It Take?

About 1 to 3 hours

Will It Hurt?

Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. You may need to stay longer if you have problems.

Post-procedure Care

At the Hospital

The staff may give you pain medicines. During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

The recovery time depends on the type of surgery. It may take 1 to 2 weeks or as long as 3 months. Physical activity will be limited during this time. You will need to delay return to work.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or any discharge from the incision
  • Pain that you cannot control with medicine
  • Lasting nausea or vomiting

If you think you have an emergency, call for medical help right away.

RESOURCES:

Myasthenia Gravis Foundation of America, Inc.
http://www.myasthenia.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Muscular Dystrophy Canada
http://www.muscle.ca

REFERENCES:

Berrih-Aknin S, Le Panse R. Thymectomy in myasthenia gravis: when, why, and how? The Lancet. 2019;18(3):225-226

General information about thymoma and thymic cancers. National Cancer Institute. Available at: http://www.cancer.gov/types/thymoma/patient/thymoma-treatment-pdq. Accessed January 13, 2021.

Myasthenia gravis. EBSCO DynaMed website. https://www.dynamed.com/condition/myasthenia-gravis. Accessed January 13, 2021.

Myasthenia gravis fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/myasthenia_gravis/detail_myasthenia_gravis.htm#84053153. Accessed January 13, 2021.

Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 1/13/2021