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Thymectomy

What is it?

A thymectomy is  an surgical procedure to remove the thymus gland which is located in the upper portion of the chest cavity, just behind the sternum. 

Why?

This procedure is most commonly done for patients with a tumour originating from the thymus or patients who have myasthenia gravis, a neuromuscular disease.

Preoperative Evaluation

You will need to undergo several tests before surgery in order to make the procedure as safe as possible.  You may require some or all of the following:

• Blood tests

• Electrocardiogram (ECG)

• CT scan
• Plasmapheresis (for myasthenia gravis patients)
• Pulmonary function tests

• See other specialists

You will also be assessed before surgery in the Pre-Admission Clinic, Zone C Level 2, to ensure all necessary procedures have been completed.

Procedure

The surgeon usually removes the gland through an incision (cut) in the middle of the chest (sternal spilt).

Time

The procedure takes approximately 2 hours and is done in the Operating Room at Victoria Hospital. You will need to register in the Admitting/Patient Registration at London Health Sciences Centre's (LHSC) Victoria Hospital located in Zone B Level 2 , at least 2 hours before your scheduled operation.

Risks

As with all surgery there are risks. The surgical risks include bleeding, infection, irregular heart beats, stroke, a reaction to anesthesia and sometimes death.

Before Your Procedure

DO NOT EAT OR DRINK ANYTHING, including water, after midnight the night before surgery unless instructed otherwise by your surgeon. Leave jewelery and valuables at home.  Ensure that you can advise the staff if you are taking any 'blood thinners' or medications. You will be directed to the Day Surgery Unit located in Zone D Level 2, where you will be assessed by a nurse and have an intravenous started. 

Family and Friends

Family and friends may wait in the Perioperative Waiting Room located in Zone D Level 2, room D2-100. Your surgeon will come to speak with them following the procedure, so it is advisable for them to wait there.

After Surgery

You will wake up in the Post Anesthesia Care Unit (PACU or 'recovery room').  You will have an intravenous tube.  You will have a drainage tube coming from below your incision.  You will be transferred to the Thoracic Observation Unit, Zone C Level 5, for the remainder of your stay.  You may eat and drink immediately after surgery. 

Pain

There is moderate pain with this surgery. You will be given medication in order to control any pain you have.

Discharge

The average patient goes home within 3 to 5 days.

You must go home with either a friend or relative by private vehicle or by taxi, NOT by public transportation. 

Dressings

Normally, the incision is left open to the air to assist in the healing process. After 2 days, you may gently wash the incision with mild soap in the shower.

Activity

You are encouraged to do your regular activities except:

• No heavy lifting for 2 months
• Do not drive a car if taking narcotics

Prescriptions

You will be given a prescription for pain control.

Follow-Up

Before you leave the hospital, your nurse will schedule a return appointment with your surgeon. This will be in approximately 4 to 6 weeks time. 

Call your surgeon's office if:

1. You have any excess:
   • Drainage from the wound
   • Pain
   • Shortness of breath
   • Dificulty swallowing

2. You have a temperature of 38.5° C (101.50° F).
   
   
3. You have any questions.