Thymectomy








J Thymectomy




1. Introduction

    The thymus gland is a bilobate mass of lymphoid tissue located deep into the sternum in the anterior region of the mediastinum. Thymectomy involves two surgical approaches: median sternotomy or transcervical.

    The thymus gland is believed to play a role in myasthenia gravis. This is a neuromuscular disorder in which postsynaptic acetylcholine receptors are attacked, inducing rapid receptor destruction.

2. Preoperative assessment and patient preparation
a) History and physical examination
(1) Respiratory (based on the patient with myasthenia gravis)

(a) Weakness of pharyngeal and laryngeal muscles is associated with a high risk of aspiration. Assess the patient’s ability to cough and handle secretions.

(b) “Myasthenic crisis”: This exacerbation involves the respiratory muscles to the point of inadequate ventilation.

(2) Cardiac: Potential cardiomyopathy

(3) Neurologic
(a) Fatigability and fluctuating motor weakness of voluntary skeletal muscles worsen with repetitive use and improve with rest.

(b) Ptosis and diplopia are initial symptoms.

(4) Endocrine: Potential hypothyroidism

b) Diagnostic tests
(1) Pulmonary function studies are obtained as indicated.

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Dec 2, 2016 | Posted by in ANESTHESIA | Comments Off on Thymectomy

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