087 Audit of thymectomy for thymoma associated and non-thymoma associated myasthenia gravis at Southampton General Hospital

Introduction In 2016, a pivotal multi-centre RCT demonstrated that thymectomy for non-thymoma asso- ciated myasthenia gravis (MG) improved clinical outcome and reduced long-term immunosuppression. We sought to review how practice has changed in Wessex following the trial. Method Patients over the age of 18 who underwent thymectomy for both thymoma and non-thymoma associated MG between 01/08/2013 and 01/08/2019 were identified using coding. Data was collected retrospectively from healthcare records. Results The number of thymectomies performed increased from 6 to 24, representing an eight-fold increase for patients with non-thymoma associated MG and three-fold increase for patients with thymoma. Time from diagnosis to surgery for patients without thymoma reduced from 8.8 years to 2.3 years. Overall 15/24 cases were performed by VATS, 12% more than previously. There was a small increase in surgical morbidity. However, 50% of patients were on reduced doses of immunosuppression by six months after surgery without deterioration in myasthenia. Conclusion Following the landmark publication in 2016, there has been a significant increase in the number of thymectomies performed in Wessex. Time to surgery has fallen, but associated surgical morbidity has increased. These observations have supported the development of a MDT in Wessex to streamline patient care and improve outcomes. c-allen@doctors.org.uk