ABSTRACT
Thymectomy has been shown to be the effective treatment of myasthenia gravis [MG]. However, this operation still had a significant perioperative morbidity in patients with MG class III, IV and V. Perioperative high dose steroid management had been recommended to improve the immediate operative results and eliminate the perioperative morbidity. Forty two patients with MG underwent thymectomy between 1977-1989 and followed up for a period ranging between 2 months and 8 years [mean 5.3 years]. Perioperative high-dose steroid management was given to 11 patients [26.2%] [group B]; while in 31 patients [73.8%], no such treatment was given [group A]. Patients in group A had required postoperative respiratory support for a period ranging from 1 day to 20 days, while all the patients in group B were extubated within 6 hours after operation. Intensive care unit stay in group A ranged between 1 week to 2 months; while in group B, only 5 patients died in group A because of complications of prolonged ventilatory support. Thymectomy resulted in 88% improvement. At follow up 7 patients had complete remission [class A], 27 class B, 3 had class C, 3 had class D and 2 had class F. Perioperative high-dose steroid management proved to be very effective in elimination of perioperative morbidity