Thymectomy
Thymectomy is the surgical removal of the thymus. The most common reason for thymectomy in the United States is to gain surgical access to the heart in surgeries to correct congenital heart defects that are performed in the neonatal period. In neonates, but not older children or adults, the relative size of the thymus obstructs surgical access to the heart. Surprisingly, removal of the thymus does not result in a T cell immunodeficiency. This is because sufficient T cells are generated during fetal life prior to birth. These T cells are long-lived and can proliferate by homeostatic proliferation throughout the lifetime of the patient. However, there is evidence of premature immune aging in patients thymectomized during early childhood.
Other indications for thymectomy include the removal of thymomas and the treatment of myastenia gravis. Thymectomy is not indicated for the treatment of primary thymic lymphomas. However, a thymic biopsy may be necessary to make the pathologic diagnosis.
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