To investigate the clinical outcomes of transverse sternotomy extended thymectomy for myasthenia gravis. Further understanding about the merits and incompetence of this approach may help to make clinical decisions.

The clinical data of 211 patients undergoing transverse sternotomy for generalized myasthenia gravis between 1998 and 2008 in Department of Cardiothoracic Surgery, Huashan Hospital affiliated to Fudan University were retrospectively studied, and the basic conditions during and after operation were analysed. The clinical outcomes were compared by χ² test between patients with thymoma and those without thymoma after follow-up for 5 years.

Transverse sternotomy was an effective approach for nonthymomatous and Masaoka-Koga stage Ⅰ or stage Ⅱ thymomatous patients, with less complications. It was convenient for intraoperative manipulation and perioperative management. Patients had a quick recovery with minimum discomfort. After follow-up for 5 years in 173 patients, the overall remission rate for myasthenia gravis was 79.8%(138/173), with no recurrence. The overall remission rates of patients with thymoma and those without thymoma were 81.9%(59/72) and 78.2%(79/101), respectively, and there was no significant differences between them (χ²=0.362, P=0.548).

Transverse sternotomy approach can be considered in the treatment of myasthenia gravis when other options are less preferred.