Present validity of “maximal” thymectomy in the treatment of myasthenia gravis

The role of the thymus in the development and pathogenesis of acetylcholine antibody myasthenia gravis is well documented. The ability of thymectomy to alter the course of the disease has been debated for many years, and now finally has been proven to clearly improve patients with the publication of the prospective randomized trial of thymectomy versus medical therapy alone. The trial definitively proves the validity of thymectomy for non-thymomatous myasthenia gravis, the maximal thymectomy surgical resection tested in the trial was critically chosen to address the anatomic presence of thymic tissue outside of the confines of the defined lobes of the thymus in the neck and mediastinum. Given the clear results of the trail, presently maximal thymectomy is the only proven valid resection in the treatment of myasthenia gravis.