A thymectomy is a surgical procedure that involves removing the thymus gland. Surgeons perform a thymectomy to treat certain autoimmune diseases and cancers.

The thymus is a small gland in the upper chest above the heart. It makes white blood cells to help fight infections.

The thymus also produces hormones, helping immune cells to develop and mature. As people age, the thymus shrinks in size, resulting in declining immune responses.

Doctors may need to remove the thymus due to cancer or autoimmune disease.

This article discusses thymectomy, the conditions it can treat, and its benefits. It looks at what happens during the procedure, how long it takes, and how people can prepare for it. It also discusses the risks of a thymectomy and how long it takes to recover.

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The most common conditions requiring a thymectomy are thymoma and myasthenia gravis.

Thymoma and thymic carcinoma are rare cancers known as thymic epithelial tumors.

Thymoma cancer cells grow slowly and rarely spread beyond the thymus, while thymic carcinoma grows more quickly and can spread to other parts of the body. Doctors are more likely to recommend thymectomy for thymoma than thymic carcinoma.

Myasthenia gravis is an autoimmune disease that causes weakness in the muscles that control breathing, swallowing, and other movements. Doctors may perform a thymectomy to help rebalance the immune system and reduce symptoms.

Other conditions that may require a thymectomy include neuroendocrine tumors and thymic cysts.

A 2021 observational study of the effects of thymectomy on 100 participants with myasthenia gravis noted that a thymectomy can help reduce the severity of symptoms and the need for medication.

An older 2016 trial involving 216 participants with the same condition found that thymectomy led to symptom improvements over 3 years.

A 2019 analysis of studies that looked at 1,223 thymectomies suggests that a minimally invasive thymectomy using video-assisted thoracoscopic and robotic methods has similar benefits to open surgery. It also results in a shorter stay in the hospital.

Surgeons may perform a thymectomy using open surgery techniques or less invasive procedures.

Median sternotomy is an open surgery technique that involves accessing the thymus through the sternum. Surgeons remove all thymic tissue and some surrounding tissue or organs.

Video-assisted thoracoscopic surgery (VATS) is minimally invasive and involves inserting surgical tools and a camera through small incisions in the chest wall. The surgeon uses the camera to guide the removal of the thymic tissue.

Another minimally invasive approach involves using surgeon-guided robots to remove thymic tissue.

A minimally invasive thymectomy takes an average of 2.5 hours, according to one case series.

The precise time the procedure takes can vary from person to person.

Before a thymectomy, doctors may order certain tests to ensure a person is fit for surgery, including lung and heart function tests.

People will typically wake up from surgery in a recovery area. They may receive supplemental oxygen or pain medications and have an intravenous (IV) drip in their arm.

A healthcare team will monitor the person to ensure their recovery goes smoothly.

A person with thymoma or thymic carcinoma may also need chemotherapy or radiation therapy following surgery to destroy any remaining cancer cells.

Additionally, depending on the reason for the thymectomy, the person may need immunotherapy.

Recovery time varies from person to person. It may also depend on whether a person has open or laparoscopic surgery.

Typical recovery times for a thymectomy are between 2 and 6 weeks.

One 2023 study looked at 1,420 participants who had a thymectomy. Researchers concluded there was an increased risk of autoimmune disease, cancer, and death.

Additionally, possible complications of a thymectomy include:

  • bleeding and damage to surrounding tissues, including the heart and nerves
  • thymoma recurrence, if the surgeon does not completely remove the thymus
  • chylothorax, which involves lymph fluid collecting in the chest cavity
  • pneumothorax (collapsed lung), which can occur when air gets into the cavity between the lungs and the chest wall
  • dysfunction of the diaphragm

Surgeons commonly perform a thymectomy to treat thymoma and myasthenia gravis.

In some cases, people may need additional treatment after surgery, such as chemotherapy, radiation therapy, or immunotherapy.

There is a risk of complications with a thymectomy, and some evidence suggests people may have an increased risk of cancer, autoimmune disease, or death.