Resumo

TAPIAS-VARGAS, Leonidas; TAPIAS-VARGAS, Luis Felipe  e  TAPIAS, Leonidas. Myasthenia gravis and the thymus: past, present, and future. rev. colomb. cir. [online]. 2009, vol.24, n.4, pp.269-282. ISSN 2011-7582.

Myasthenia gravis is an autoimmune neuromuscular disease characterized by weakness and fatigability of striated muscle. It was recognized three centuries ago, but therapeutic interventions that decrease symptoms and alter the clinical course of the disease have just been developed until the 20th century. The thymus plays a central role in the physiopathology since it has all the elements required to initiate and mount an immune response against self-antigens, especially the acetilcholine receptor at the motor plate. Because of this, extended thymectomy has arisen as a therapeutic alternative that accomplishes complete remission of the disease in as much as 75% of patients and improvement in 99%. However, conventional open surgical approach (sternotomy) is aggressive, hence in the last decade video-assisted thoracic surgery has developed surgical techniques capable of performing the same procedure but with fewer complications and better cosmetic results. Because of the beneficial effects shown, surgical treatment must be offered to all patients with generalized myasthenia gravis and to a large proportion of those with ocular symptoms alone.

Palavras-chave : miastenia gravis; timo; timectomía; cirugía torácica asistida por video; myasthenia gravis; thymus gland; thymectomy; thoracic surgery; video-assisted.

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