top of page

MEDIASTINAL CONDITIONS

Throughout the years, I’ve compiled information and advice from experts in the medical field regarding a variety of health care topics. I’ve tried to cover a variety of relevant subjects to help educate you and your loved ones. However, if there’s still something unclear or you have additional questions, please don’t hesitate to let me know.

Patient Information:

Mediastinal Tumours –

Diagnosis and Management
 

This information sheet is designed to help you understand more about tumours that can occur in the mediastinum, how they are diagnosed, and the different ways they can be treated.
 

What is the Mediastinum?
 

The mediastinum is the space in the middle of your chest, located between your lungs. It contains many important organs and structures, including:

  • The heart and major blood vessels (like the aorta, vena cava).

  • The trachea (windpipe) and main bronchi (airways leading to the lungs).

  • The esophagus (food pipe).

  • Lymph nodes (small glands that are part of the immune system).

  • The thymus gland (an organ involved in immune system development).

  • Nerves (e.g., phrenic nerve, vagus nerve, sympathetic chain).


The mediastinum is often divided into three or four compartments for descriptive purposes:

  • Anterior (front) mediastinum: Contains the thymus gland, lymph nodes, and fatty tissue.

  • Middle mediastinum: Contains the heart, pericardium (sac around the heart), trachea, main bronchi, and lymph nodes.

  • Posterior (back) mediastinum: Contains the esophagus, descending aorta, thoracic duct (a major lymphatic vessel), nerves, and lymph nodes.

    (Some classifications also include a superior mediastinum).


What are Mediastinal Tumours?
 

A mediastinal tumour is an abnormal growth of cells that develops in any of the tissues or organs located within the mediastinum. These tumours can be:

  • Benign (Non-cancerous): These tumours do not spread to other parts of the body and are usually not life-threatening. However, they can grow and cause symptoms by pressing on nearby organs.

  • Malignant (Cancerous): These tumours can invade nearby tissues and organs, and can spread (metastasize) to other parts of the body.
     

Mediastinal tumours can arise from any structure within the mediastinum. They are relatively uncommon.
 

Types of Mediastinal Tumours
 

The types of tumours found in the mediastinum vary depending on the compartment and the age of the patient.
 

Common Tumours by Compartment:
 

  • Anterior Mediastinum:

    • Thymoma and Thymic Carcinoma: Tumours of the thymus gland (most common primary tumours in adults). Thymomas can be benign or malignant; thymic carcinomas are always malignant. Some thymomas are associated with autoimmune conditions like Myasthenia Gravis.

    • Lymphoma: Cancer of the lymph nodes (e.g., Hodgkin lymphoma, Non-Hodgkin lymphoma). This is one of the most common mediastinal malignancies.

    • Germ Cell Tumours: These arise from cells that would normally develop into sperm or eggs. They can be benign (e.g., mature teratoma) or malignant (e.g., seminoma, non-seminomatous germ cell tumours). More common in young men.

    • Thyroid masses (e.g., goiter extending into the chest).

  • Middle Mediastinum:

    • Lymphoma.

    • Metastatic cancer (spread from other organs like the lung).

    • Pericardial cysts (benign fluid-filled sacs around the heart).

    • Bronchogenic cysts (benign cysts arising from airway tissue).

  • Posterior Mediastinum:

    • Neurogenic Tumours: Tumours arising from nerve tissue (e.g., schwannoma, neurofibroma, ganglioneuroma – often benign; neuroblastoma, ganglioneuroblastoma – often malignant, more common in children). These are the most common posterior mediastinal tumours.

    • Esophageal tumours.

    • Bronchogenic cysts.

    • Lymphoma.
       

What are the Symptoms?
 

About one-third to one-half of people with mediastinal tumours have no symptoms, and the tumour is found incidentally on an imaging test done for another reason.
 

When symptoms do occur, they are often due to the tumour pressing on or invading nearby structures. Symptoms can include:

  • Cough (often dry and persistent).

  • Shortness of breath or difficulty breathing.

  • Chest pain or discomfort (can be dull, sharp, or a feeling of pressure).

  • Hoarseness or voice changes (if the nerve to the voice box is affected).

  • Difficulty swallowing (dysphagia) (if the esophagus is compressed).

  • Wheezing or stridor (a high-pitched breathing sound).

  • Swelling of the face, neck, and arms (Superior Vena Cava Syndrome - SVCS): If a large vein called the superior vena cava is compressed. This is a serious sign.

  • Horner's Syndrome: Drooping eyelid, constricted pupil, decreased sweating on one side of the face (if certain nerves are affected).

  • Systemic symptoms (more common with malignant tumours or specific conditions):

    • Fever, night sweats, unexplained weight loss (common with lymphoma).

    • Muscle weakness (e.g., in Myasthenia Gravis associated with thymoma).

    • Hormonal symptoms (rare, with some germ cell tumours or endocrine tumours).
       

How are Mediastinal Tumours Diagnosed?
 

  1. Medical History and Physical Examination: Your doctor will ask about your symptoms, medical history, and family history. A thorough physical examination will be performed.

  2. Imaging Tests:

    • Chest X-ray: Often the first test that shows an abnormal shadow or widening of the mediastinum.

    • CT Scan (Computed Tomography): This is a key imaging test. It provides detailed cross-sectional images, showing the exact location, size, shape, and characteristics of the tumour, and its relationship to surrounding structures. Contrast dye is usually given.

    • MRI Scan (Magnetic Resonance Imaging): Can be very useful for further characterising tumours, especially neurogenic tumours or when assessing invasion into blood vessels or the spinal canal.

    • PET Scan (Positron Emission Tomography): Often combined with a CT scan (PET-CT). This scan can help determine if a tumour is cancerous, how active it is, if it has spread (staging), and can be used to monitor response to treatment.

    • Ultrasound (Endobronchial - EBUS, or Endoscopic - EUS): Specialized ultrasound probes on the end of a flexible scope can be passed down the airway (EBUS) or esophagus (EUS) to view and biopsy lymph nodes or masses in the mediastinum.

    • Octreotide Scan or MIBG Scan: Specialised scans sometimes used for neuroendocrine tumours.

  3. Blood Tests:

    • General blood tests to assess overall health.

    • Tumour markers: Specific substances that can be elevated in the blood with certain tumours (e.g., Alpha-fetoprotein (AFP) and Human Chorionic Gonadotropin (hCG) for germ cell tumours; antibodies for Myasthenia Gravis with thymoma).

  4. Biopsy: A biopsy is almost always needed to get a definitive diagnosis, determining if the tumour is benign or malignant and its specific type. The way a biopsy is obtained depends on the location and accessibility of the tumour:

    • Needle Biopsy (Image-Guided): A thin needle is inserted through the chest wall into the tumour under CT or ultrasound guidance to obtain a tissue sample.

    • Endobronchial Ultrasound (EBUS)-guided Transbronchial Needle Aspiration (TBNA): A bronchoscope with an ultrasound probe is used to guide a needle through the airway wall into the tumour or lymph nodes.

    • Endoscopic Ultrasound (EUS)-guided Fine Needle Aspiration (FNA): An endoscope with an ultrasound probe is passed down the esophagus to guide a needle into nearby mediastinal masses.

    • Mediastinoscopy: A surgical procedure where a small incision is made at the base of the neck. A thin, lighted tube (mediastinoscope) is inserted behind the sternum to view and biopsy tumours or lymph nodes in the anterior and middle mediastinum. Performed under general anaesthesia.

    • Video-Assisted Thoracoscopic Surgery (VATS): A keyhole surgical procedure where small incisions are made in the chest. A camera and instruments are used to biopsy or sometimes remove the tumour. Performed under general anaesthesia.

    • Thoracotomy (Open Surgery): A larger surgical incision may be needed for biopsy if other methods are not feasible or if complete removal is planned at the same time.
       

How are Mediastinal Tumours Managed?
 

Treatment depends on many factors, including:

  • The specific type of tumour (benign or malignant, and its subtype).

  • The stage of the cancer (if malignant), meaning its size and whether it has spread.

  • The location of the tumour and whether it's affecting nearby structures.

  • Your overall health and preferences.
     

A Multidisciplinary Team (MDT) of specialists (including thoracic surgeons, oncologists, radiation oncologists, pathologists, radiologists) will discuss your case and recommend the best treatment plan.
 

1. Surgery
 

Surgery is a common treatment, especially for:

  • Most benign mediastinal tumours: Surgical removal is often curative and prevents them from growing and causing symptoms.

  • Many primary malignant mediastinal tumours: Such as thymomas, thymic carcinomas, resectable germ cell tumours, and neurogenic tumours. The goal is complete removal of the tumour, sometimes with surrounding tissue or lymph nodes.

  • Diagnostic purposes: As mentioned (VATS, mediastinoscopy, thoracotomy) when a biopsy is needed and sometimes the entire tumour can be removed at the same time if it's small and appears benign or well-localised.
     

The surgical approach depends on the tumour's location, size, and type:

  • Minimally Invasive Surgery (VATS or Robotic-Assisted Thoracic Surgery - RATS): Often preferred for smaller, accessible tumours. Involves small incisions, leading to quicker recovery.

  • Mediastinoscopy: Primarily for biopsy, but some small anterior tumours can be removed this way.

  • Sternotomy: An incision through the sternum (breastbone). Often used for large anterior mediastinal tumours (e.g., large thymomas) or those involving structures on both sides.

  • Thoracotomy: An incision on the side of the chest between the ribs. Used for tumours in the middle or posterior mediastinum, or if VATS is not suitable.
     

2. Radiotherapy (Radiation Therapy)
 

Radiotherapy uses high-energy rays to kill cancer cells or stop them from growing. It may be used:

  • As the primary treatment: For some cancers like lymphoma, or for tumours that cannot be surgically removed.

  • After surgery (Adjuvant Radiotherapy): To kill any remaining cancer cells and reduce the risk of recurrence (e.g., for some thymomas, thymic carcinomas, or incompletely resected tumours).

  • Before surgery (Neoadjuvant Radiotherapy): Sometimes used to shrink a tumour to make it easier to remove.

  • Palliative Radiotherapy: To relieve symptoms (e.g., pain, airway obstruction, SVCS) if the cancer is advanced or has recurred.
     

3. Chemotherapy
 

Chemotherapy uses anti-cancer drugs to kill cancer cells. It is often the main treatment for:

  • Lymphomas.

  • Malignant Germ Cell Tumours.

  • Leukemias that may involve the mediastinum.

  • Metastatic cancer that has spread to the mediastinum.
     

Chemotherapy may also be used:

  • Before surgery (Neoadjuvant Chemotherapy): To shrink tumours like germ cell tumours or some sarcomas.

  • After surgery (Adjuvant Chemotherapy): To reduce the risk of recurrence for certain cancers.

  • In combination with radiotherapy (Chemoradiotherapy).
     

4. Other Treatments
 

  • Hormone Therapy: For certain types of tumours.

  • Targeted Therapy and Immunotherapy: These are newer treatments that are becoming options for specific types of cancers, and their role in mediastinal tumours is an active area of research.

  • Watchful Waiting (Observation): For some small, clearly benign tumours that are not causing symptoms, regular monitoring with imaging may be an option instead of immediate removal.

  • Treatment for Associated Conditions: E.g., treatment for Myasthenia Gravis if present with a thymoma.
     

What to Expect (General Points)
 

  • Before Treatment: A thorough evaluation and discussion with your MDT. You'll understand the diagnosis, treatment plan, goals, benefits, and potential side effects.

  • During Treatment: This will depend on the chosen therapy. Surgery involves a hospital stay. Chemotherapy and radiotherapy are often outpatient treatments over weeks or months.

  • After Treatment: Regular follow-up is essential.
     

Recovery and Follow-Up
 

  • After Surgery: Recovery time varies significantly depending on the type of surgery. Pain management, wound care, and physiotherapy (especially breathing exercises) are important.

  • Follow-up Care: Essential for monitoring for recurrence or late side effects. This involves regular clinic visits, physical exams, blood tests, and imaging scans (CT, PET-CT, X-ray) for many years.

  • Managing Side Effects: Your team will help you manage any short-term or long-term side effects of treatment.
     

When to Contact Your Doctor
 

Contact your doctor or specialist nurse if you experience:

  • New or worsening symptoms (e.g., cough, shortness of breath, chest pain, difficulty swallowing).

  • Signs of infection after surgery (fever, redness/swelling at wound site).

  • Significant side effects from chemotherapy or radiotherapy.

  • Any new lumps or swellings.

  • Unexplained weight loss, persistent fatigue, or night sweats.
     

Support
 

A diagnosis of a mediastinal tumour can be worrying. It's important to seek support from your healthcare team, family, friends, and patient support organizations. They can provide information, emotional support, and practical help.
 

Disclaimer: This information sheet provides general guidance and is not a substitute for professional medical advice, diagnosis, or treatment. The management of mediastinal tumours is complex and depends on your individual circumstances. Always discuss your specific condition, treatment options, risks, and benefits thoroughly with your medical team.

Taking blood pressue

Patient Information:

Operations on the Mediastinum

​

This information sheet is designed to help you understand the different types of surgical operations that are performed on the mediastinum (the area in the middle of your chest).

​

What is the Mediastinum? (A Brief Recap)

​

The mediastinum is the space in your chest between your lungs. It contains a group of vital organs and structures, including the heart, major blood vessels, trachea (windpipe), esophagus (food pipe), thymus gland, and lymph nodes.

​

Why is Surgery on the Mediastinum Needed?

​

Your doctor may recommend an operation on your mediastinum for several reasons:

  • For Diagnosis (Biopsy): To obtain a tissue sample from a tumour or enlarged lymph node to find out exactly what it is. A definitive diagnosis is crucial for planning the correct treatment.

  • To Treat a Condition: To completely remove a growth or mass. This is the primary treatment for most benign (non-cancerous) and many malignant (cancerous) mediastinal tumours, such as thymomas, neurogenic tumours, and germ cell tumours.

  • For Cancer Staging: To determine if cancer (e.g., lung cancer) has spread to the mediastinal lymph nodes. This information helps doctors decide on the best overall treatment plan.

 

Types of Mediastinal Operations

​

The type of operation you have depends on the reason for the surgery, and the size, type, and location of the mass or lymph nodes being targeted.

​

1. Mediastinoscopy

​

  • What it is: A procedure used to look at and take biopsies from the lymph nodes and structures in the front and middle parts of the mediastinum.

  • How it's done: A small incision (cut) is made at the base of your neck, just above the breastbone. A thin, lighted tube with a camera (a mediastinoscope) is gently passed behind your breastbone into the mediastinum. The surgeon can view the area and pass small instruments through the scope to take tissue samples.

  • Main use: Primarily for diagnosis and cancer staging.

  • ​

2. Video-Assisted Thoracoscopic Surgery (VATS) or Robotic-Assisted Thoracic Surgery (RATS)

​

  • What it is: A minimally invasive "keyhole" approach to the chest.

  • How it's done: The surgeon makes two or three small incisions on the side of your chest. A tiny camera and specialised long instruments are inserted through these incisions. For RATS, the surgeon controls robotic arms to perform the operation. This approach allows the surgeon to see inside the chest and perform complex procedures like biopsies or tumour removal.

  • Main use: Diagnosis (biopsy) and removal of small to medium-sized tumours, especially those in the anterior or posterior mediastinum. This approach often results in less pain, a shorter hospital stay, and faster recovery.

​

3. Sternotomy

​

  • What it is: An "open" surgical approach that involves dividing the sternum (breastbone) down the middle.

  • How it's done: An incision is made down the front of the chest, and the sternum is divided. This gives the surgeon a wide, direct view of the entire anterior mediastinum and the heart and major blood vessels. After the procedure, the sternum is brought back together with strong wires.

  • Main use: For removing large tumours in the anterior mediastinum (e.g., large thymomas) or tumours that are close to or invading the major blood vessels.

 

4. Thoracotomy

​

  • What it is: An "open" surgical approach that involves an incision on the side of the chest, between the ribs.

  • How it's done: The surgeon makes an incision and spreads the ribs apart to access the mediastinum and lung. This provides a wide view of the side of the mediastinum.

  • Main use: For removing large tumours, especially those in the posterior or middle mediastinum that are not suitable for a VATS/RATS approach.

 

What to Expect Before Surgery

​

  • Pre-operative Assessment: You will have various tests to ensure you are fit for the operation and general anaesthesia. This may include blood tests, an ECG (heart tracing), lung function tests, and imaging scans like a CT scan.

  • Discussion with Your Team: Your surgeon and anaesthetist will explain the operation, its goals, the expected benefits, and the potential risks. This is your opportunity to ask any questions you have.

  • Consent: You will be asked to sign a consent form once you understand and agree to the procedure.

  • Fasting: You will be instructed not to eat or drink for several hours before the operation.

  • Medications: Your team will advise you on which of your regular medications to take or stop before surgery (especially blood thinners).

 

What Happens During the Operation?

  • You will be given a general anaesthetic, which means you will be fully asleep and will not feel anything during the procedure.

  • A breathing tube will be placed in your windpipe and connected to a ventilator to manage your breathing.

  • You will be positioned on the operating table depending on the surgical approach (e.g., on your back for a sternotomy, on your side for a thoracotomy or VATS).

  • The surgeon will perform the planned procedure.

  • At the end of the operation, one or more chest drains (flexible plastic tubes) may be placed in your chest to drain any fluid or air.

  • The incisions will be closed with stitches or staples.

 

What to Expect After Surgery

  • Recovery Room: You will wake up in a recovery room, where nurses will monitor your vital signs (heart rate, blood pressure, oxygen levels) closely.

  • Pain: You will have some pain or discomfort around the incision sites. This will be controlled with pain medication, which may be given intravenously (IV), as tablets, or via a nerve block or epidural catheter. Good pain control is important so you can breathe deeply and cough.

  • Tubes and Drips: You will likely wake up with an IV drip for fluids, a catheter in your bladder, and one or more chest drains. These will be removed as you recover.

  • Chest Drains: These will stay in place for a few days to help your lung stay fully expanded.

  • Breathing Exercises: A physiotherapist will teach you breathing and coughing exercises to help prevent chest infections and clear your lungs.

  • Mobilisation: You will be encouraged to get out of bed and start moving around (with assistance) as early as possible to help your recovery and prevent complications like blood clots.

  • Hospital Stay: The length of your stay will depend on the type of operation and your recovery. It can range from 1-2 days for a simple biopsy to a week or more for a major open procedure.

 

Potential Risks and Complications

 

All operations carry risks. Your surgeon will discuss these with you. For mediastinal surgery, they can include:

  • General Risks of Anaesthesia.

  • Pain: Can be significant, but is managed with medication. Some patients may develop persistent pain.

  • Bleeding: May require a blood transfusion or, rarely, a return to the operating theatre.

  • Infection: Of the wound or inside the chest (pneumonia).

  • Nerve Injury:

    • Injury to the recurrent laryngeal nerve can cause a hoarse voice.

    • Injury to the phrenic nerve can cause paralysis of the diaphragm on one side, leading to shortness of breath.

    • Injury to nerves between the ribs can cause numbness or persistent pain around the scar.

  • Air Leak: A persistent leak of air from the lung, which may require the chest drain to stay in for longer.

  • Injury to nearby structures: Such as the heart, major blood vessels, or esophagus (this is rare with experienced surgeons).

  • Blood Clots: In the legs (DVT) or lungs (PE).

  • For Sternotomy: Problems with sternal bone healing.

 

Recovery and Follow-Up

  • At Home: You will be given instructions on how to care for your wounds, manage your pain, and when to resume activities. You will likely feel tired for several weeks.

  • Activity: You will need to avoid heavy lifting and strenuous activity for 4-6 weeks or more, depending on your operation. Your surgeon will give you specific advice.

  • Driving: You can resume driving when you are free from significant pain and can safely perform an emergency stop.

  • Follow-up: You will have a follow-up appointment in the outpatient clinic, usually a few weeks after discharge, to check on your recovery and discuss the results of any tissue analysis (pathology). Long-term follow-up will depend on your diagnosis.

 

When to Contact Your Doctor After Discharge

​

You should contact your doctor or the hospital if you experience:

  • Fever or chills.

  • Redness, swelling, warmth, or discharge (pus) from your wound.

  • Increasing pain that is not controlled by your medication.

  • New or worsening shortness of breath or chest pain.

  • Coughing up blood.

  • Pain or swelling in your calf.​

 

Disclaimer: This information sheet provides general guidance and is not a substitute for professional medical advice, diagnosis, or treatment. The decision to have surgery and the choice of procedure are complex. Always discuss your specific condition, treatment options, risks, and benefits thoroughly with your thoracic surgeon and healthcare team.

Doctors Looking at X- Rays

Patient Information:

Thymectomy for Myasthenia Gravis

​

​

This information sheet is designed to help you understand Myasthenia Gravis (MG) and the role of thymectomy (surgical removal of the thymus gland) as part of your treatment.

​

What is Myasthenia Gravis (MG)?

​

Myasthenia Gravis is an autoimmune condition that causes weakness in the voluntary muscles (the muscles you can consciously control). In an autoimmune condition, the body's immune system mistakenly attacks its own healthy tissues. In MG, the immune system produces antibodies that block or damage the receptors at the junction where nerves connect to muscles. This prevents muscles from receiving nerve signals properly, leading to muscle weakness that typically worsens with activity and improves with rest.

​

Commonly affected muscles include those that control:

  • Eye and eyelid movement (causing droopy eyelids or double vision).

  • Facial expression, chewing, and swallowing.

  • Speaking.

  • Limb movement (arms and legs).

  • Breathing.

 

MG is managed by a neurologist, usually with medications that help improve muscle strength (like pyridostigmine) or suppress the immune system (like steroids or other immunosuppressants).

​

What is the Thymus Gland and its Role in MG?

​

The thymus is a small gland located in the mediastinum (the area in your chest behind the breastbone and in front of the heart).

It is an important part of the immune system, especially during childhood, as it's where immune cells called T-lymphocytes mature. After puberty, the thymus gland normally shrinks and is replaced by fatty tissue.

In many people with MG, the thymus gland is abnormal. It may remain large (thymic hyperplasia) or, in about 10-15% of cases, a tumour may develop on the gland, most commonly a benign (non-cancerous) or low-grade tumour called a thymoma.

The abnormal thymus gland is thought to play a central role in producing the harmful antibodies that cause MG.

​

What is a Thymectomy and Why is it Recommended for MG?

​

A thymectomy is the surgical removal of the thymus gland. This operation is a well-established treatment for MG and is recommended for two main reasons:

  1. To Remove a Thymoma: If a thymoma is present, surgery is necessary to remove it, as even benign thymomas can grow and press on nearby structures, and some have the potential to become cancerous or spread.

  2. To Improve MG Symptoms: In patients without a thymoma (particularly younger patients with generalized MG), removing the thymus gland can significantly improve muscle strength and reduce the need for medication. By removing the source of the abnormal immune signals, the body may gradually reduce the production of the harmful antibodies.

 

It is important to understand that the benefits of thymectomy for improving MG symptoms are not immediate. It can take months, or even a few years, for patients to notice the full effect as the immune system slowly re-adjusts. The goal is to achieve remission (no symptoms without medication) or to significantly reduce symptoms and the amount of medication required.

​

Types of Thymectomy Operations

​

The entire thymus gland must be removed for the operation to be effective. This is usually done using one of the following surgical approaches:

​

1. Minimally Invasive Thymectomy (VATS or RATS)

  • What it is: A "keyhole" approach. VATS stands for Video-Assisted Thoracoscopic Surgery, and RATS for Robotic-Assisted Thoracic Surgery.

  • How it's done: The surgeon makes several small incisions on the side of the chest or at the base of the neck. A tiny camera and specialized long instruments (or robotic arms for RATS) are inserted. This allows the surgeon to remove the thymus gland without a large incision.

  • Advantages: This approach usually results in less pain, a shorter hospital stay, smaller scars, and a faster overall recovery. It is the most common approach for patients without a large thymoma.

 

2. Sternotomy (Open Thymectomy)

  • What it is: An open surgical approach that involves dividing the sternum (breastbone) down the middle.

  • How it's done: An incision is made down the front of the chest, and the sternum is divided to give the surgeon a wide, direct view. After the thymus is removed, the sternum is rejoined with strong wires.

  • Advantages: This approach provides excellent access and is often used for patients with large thymomas or if the tumour is invading nearby structures.

 

Your surgeon will discuss which approach is most suitable for you based on the size of your thymus gland, the presence and size of any thymoma, and your overall health.

​

What to Expect Before Surgery

​

  • Neurological Assessment: Your neurologist will ensure your MG is as well-controlled as possible before surgery. You may need adjustments to your medication or treatments like plasmapheresis or IVIG (intravenous immunoglobulin) to get you in the best possible condition for the operation.

  • Pre-operative Assessment: You will have tests to check your fitness for surgery and anaesthesia, including blood tests, an ECG (heart tracing), and lung function tests.

  • Discussion with Your Team: Your surgeon and anaesthetist will explain the operation, its goals, benefits, and risks. This is your chance to ask questions.

  • Consent and Fasting: You will be asked to sign a consent form and will be instructed to stop eating and drinking for several hours before the operation.

 

What to Expect After Surgery

​

  • Recovery and Monitoring: You will wake up in a recovery area or sometimes a high-dependency or intensive care unit, where you can be monitored closely. This is a standard precaution for patients with MG, as the stress of surgery can sometimes temporarily worsen muscle weakness.

  • Pain Management: You will have some pain, which will be carefully managed with medication. Good pain relief is important to allow you to breathe deeply.

  • MG Management: Your neurology and anaesthetic teams will carefully manage your MG medications to keep you strong.

  • Breathing and Mobilisation: A physiotherapist will help you with breathing exercises and encourage you to get up and moving as soon as possible to aid recovery and prevent complications.

  • Hospital Stay: This can range from a few days to a week or more, depending on the surgical approach and your recovery.

  • Sternal Precautions (for Sternotomy): If you have a sternotomy, you will be given specific instructions on how to move and what activities to avoid for about 6-8 weeks to allow the breastbone to heal properly.

 

Potential Risks and Complications

 

All operations have risks. For thymectomy, these include:

  • MG Flare-up (Myasthenic Crisis): The stress of surgery can temporarily worsen MG weakness, which could affect your breathing. This is why you are monitored so closely after the operation.

  • General surgical risks: Bleeding, infection of the wound or chest, blood clots in the legs (DVT) or lungs (PE).

  • Nerve Injury: There is a small risk of injury to nerves near the thymus, such as the phrenic nerve (which controls the diaphragm), which can cause shortness of breath.

  • Injury to nearby structures: Such as the heart or major blood vessels (this is rare with experienced surgeons).

  • Complications of a Sternotomy: Such as problems with bone healing.

 

Recovery and Long-Term Outlook

​

  • At Home: You will feel tired for several weeks. You will be given instructions on wound care, pain management, and activity. Avoid heavy lifting for 4-6 weeks (or longer after a sternotomy).

  • Follow-up: You will have follow-up appointments with both your surgeon and your neurologist.

  • Benefits: As mentioned, improvement in MG symptoms is gradual. Studies show that a significant percentage of patients achieve remission or have a marked improvement in their symptoms in the years following surgery. Your neurologist will guide you on if and when your medications can be reduced.

 

When to Contact Your Doctor After Discharge

​

Contact your surgical team or neurologist if you experience:

  • Signs of wound infection (redness, swelling, discharge, fever).

  • Increasing chest pain or shortness of breath.

  • Significant worsening of your MG symptoms (e.g., increased weakness, difficulty swallowing or breathing).

  • Pain or swelling in your calf.

 

Disclaimer: This information sheet provides general guidance and is not a substitute for professional medical advice, diagnosis, or treatment. The decision to have a thymectomy is made jointly between you, your neurologist, and your thoracic surgeon. Always discuss your specific condition, treatment options, risks, and benefits thoroughly with your medical team.

Doctor with Files

Website Medical Disclaimer

​

(1) No Advice:

This website contains general information about medical conditions and treatments. The information is not advice, and should not be treated as such.

(2) No Warranties:

The medical information on this website is provided without any representations or warranties, express or implied. We make no representations or warranties in relation to the medical information on this website.

Without prejudice to the generality of the foregoing paragraph, we do not warrant that:

(a) the medical information on this website will be constantly available, or available at all; or

(b) the medical information on this website is complete, true, accurate, up-to-date, or non-misleading.

(3) Professional Assistance:

You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

(4) Limiting Our Liability:

Nothing in this medical disclaimer will:

(a) limit or exclude our liability for death or personal injury resulting from negligence;

(b) limit or exclude our liability for fraud or fraudulent misrepresentation;

(c) limit any of our liabilities in any way that is not permitted under applicable law; or

(d) exclude any of our liabilities that may not be excluded under applicable law.

(5) This Disclaimer:

This medical disclaimer was made using a precedent created by SEQ Legal  and available on Website Law.

bottom of page