With the establishment of our research center for the treatment of myasthenia gravis (thymoma), the number of thymoma patients coming to our thoracic surgery department from all over the country has increased rapidly, especially in combination with myasthenia gravis thymoma. In the first 4 months of this year, more than 40 such patients were treated in our department, 38 of which were done under minimally invasive thoracoscopic conditions. However, there are some difficult or severe patients, and the most important characteristics of these patients are: 1) thymoma invasion is very heavy, including 6 cases invading important arteries. Although we have been internationally known for our difficult minimally invasive thoracoscopic surgery, complete open-heart resection should be considered for huge thymomas that may invade the superior vena cava or the innominate vein. Complete resection of thymoma and thymus as well as ectopic thymus can improve the long-term outcome and the remission rate of myasthenia gravis. 2. Combined myasthenia gravis is severe, and myasthenia gravis often goes through a period of exacerbation after surgical treatment. After individualized and comprehensive treatment, they all remit significantly. It also gave us valuable clinical experience in the study of diagnosis and treatment of myasthenia gravis and thymoma. 3. Most patients are young and must be treated by an expanded resection approach to better improve the long-term outcome. 4.With the deepening of multidisciplinary cooperation, the progress of pathogenesis exploration, the accumulation of diagnosis and treatment experience and the improvement of surgical techniques, we have been able to improve the perioperative treatment of myasthenia gravis and myasthenia gravis crisis, which shortens the hospitalization time in ICU, reduces the patient’s expenses and alleviates the patient’s pain, so that the patient can get rid of from the surgery as early as possible. In addition, among these patients, there were three patients who failed to have complete resection or recurrent cases in other hospitals, and we improved the prognosis of these patients with thymoma by reoperation (or thoracoscopic hot irrigation treatment).