{"id":18628,"date":"2020-01-30T11:38:41","date_gmt":"2020-01-30T10:38:41","guid":{"rendered":"https:\/\/devhml.givememore.net\/qui-sommes-nous\/historique-pediatrique\/"},"modified":"2022-04-29T14:14:47","modified_gmt":"2022-04-29T12:14:47","slug":"historique-pediatrique","status":"publish","type":"page","link":"https:\/\/devhml.givememore.net\/hopital\/presentation\/historique-pediatrique\/","title":{"rendered":"Historique p\u00e9diatrique"},"content":{"rendered":"\n

Pour comprendre l\u2019histoire de l’H\u00f4pital Marie-Lannelongue et plus particuli\u00e8rement celle du P\u00f4le des Cardiopathies Cong\u00e9nitales, il faut remonter \u00e0 1885 et \u00e0 la cr\u00e9ation de la Ligue Fraternelle des Enfants de France pour venir en aide aux enfants malheureux, avec la cr\u00e9ation d\u2019un dispensaire.<\/strong><\/p>\n\n\n\n

Une tradition : pr\u00e9vention de l\u2019enfance, soins des enfants et chirurgie infantile<\/h3>\n\n\n\n
\"p\u00e9diatrie\"<\/figure><\/div>\n\n\n\n

D\u00e8s 1909, le dispensaire Marie Lannelongue assure des consultations pour les enfants et une assistance m\u00e9dicale (soins temporaires), notamment en oto-rhino-laryngologie et ophtalmologie. L\u2019h\u00f4pital, destin\u00e9 depuis 1912 \u00e0 la chirurgie g\u00e9n\u00e9rale et infantile, a toutefois une forte activit\u00e9 en chirurgie orthop\u00e9dique, dont le service est dirig\u00e9 par le Dr. Henri Mayet (1867-1941), chirurgien \u00e0 l\u2019h\u00f4pital Saint-Joseph. Cette orientation sp\u00e9cifique, s\u2019inscrit dans le contexte de l\u2019essor de la chirurgie infantile associ\u00e9e \u00e0 l\u2019orthop\u00e9die, avec la cr\u00e9ation \u00e0 Paris en 1899 de la premi\u00e8re chaire de clinique chirurgicale des maladies des enfants. Install\u00e9e \u00e0 l\u2019h\u00f4pital Trousseau (1901), puis en 1903 \u00e0 l\u2019h\u00f4pital des Enfants Malades, elle se d\u00e9nomme en 1920, clinique chirurgicale infantile et orthop\u00e9die.<\/p>\n\n\n\n

Durant l\u2019entre-deux-guerres, une consultation r\u00e9put\u00e9e de neuropsychiatrie infantile se d\u00e9veloppe ainsi qu\u2019un \u00ab h\u00f4pital de jour \u00bb pour enfants dans le cadre de la lutte contre la tuberculose. Cette derni\u00e8re orientation (placement des enfants \u00e0 la campagne, envoi en pr\u00e9ventorium\u2026) correspond \u00e0 l\u2019ambition de la Ligue fran\u00e7aise des enfants de France (LFEF) de participer \u00e0 la prophylaxie antituberculeuse d\u00e9finie d\u00e8s 1878 par Joseph Grancher (1843-1907), professeur des maladies des enfants \u00e0 l\u2019h\u00f4pital des Enfants Malades (1885), membre de la LFEF, pr\u00e9sident du conseil d\u2019administration de l\u2019Institut Pasteur et fondateur en 1903 de l\u2019Oeuvre de pr\u00e9vention de l\u2019enfance contre la tuberculose. Enfin, \u00e0 partir du d\u00e9but des ann\u00e9es 1920, la consultation des nourrissons se d\u00e9veloppe pour repr\u00e9senter au milieu des ann\u00e9es 1950, plus de 72 % des consultations d\u2019enfants de moins de 15 ans.<\/p>\n\n\n\n

L\u2019H\u00f4pital Marie-Lannelongue \u00e0 l\u2019avant-garde d\u2019une nouvelle orientation en chirurgie p\u00e9diatrique et n\u00e9onatale<\/h3>\n\n\n\n

Depuis les travaux pionniers des professeurs Odilon Lannelongue (1840-1911) sur les affections cong\u00e9nitales (1894), Auguste Broca (1859-1924) sur la \u00ab Chirurgie infantile \u00bb (Trait\u00e9, 1914), Louis Ombredanne (1871-1936) sur la \u00ab Clinique op\u00e9ratoire de chirurgie infantile \u00bb (Pr\u00e9cis, 1923), les chirurgiens anglo-saxons, plus particuli\u00e8rement William E. Ladd (1880-1967), rejoint au Children\u2019s Hospital de Boston par Robert E. Gross (1905-1988), ont ouvert la voie d\u00e8s les ann\u00e9es 1940-1950, \u00e0 la chirurgie visc\u00e9rale de l\u2019enfant et au traitement des malformations du nouveau-n\u00e9, sp\u00e9cialement celles qui sont incompatibles avec la vie. Alors qu\u2019ils font \u00e9cole aupr\u00e8s de jeunes chirurgiens durant la p\u00e9riode 1950-1960, l\u2019H\u00f4pital Marie-Lannelongue se situe, quant \u00e0 lui, \u00e0 l\u2019avant-garde de ce processus, puisque d\u00e8s 1946 la vocation p\u00e9diatrique de l\u2019h\u00f4pital est maintenue, mais orient\u00e9e dor\u00e9navant vers la cardiologie infantile, afin d\u2019op\u00e9rer les enfants atteints de cardiopathies cong\u00e9nitales (les enfants bleus, notamment).<\/p>\n\n\n\n

Suivant les avis et conseils des professeurs Robert Debr\u00e9 (1882-1978), fondateur de l\u2019\u00e9cole fran\u00e7aise de p\u00e9diatrie, Fran\u00e7ois Gaudart d\u2019Allaines (1892-1974) de l\u2019h\u00f4pital Broussais et du doyen Binet (1891-1971) de la facult\u00e9 de m\u00e9decine de Paris, l\u2019H\u00f4pital Marie-Lannelongue se transforme officiellement \u00e0 l\u2019automne 1949 en un centre de chirurgie intra-thoracique (cardio-vasculaire et pulmonaire), r\u00e9serv\u00e9 en principe aux enfants mais \u00e9galement ouvert \u00e0 un certain nombre d\u2019adultes. D\u00e8s son inauguration en 1953, les orientations de l\u2019H\u00f4pital Marie-Lannelongue en chirurgie p\u00e9diatrique sont affirm\u00e9es par son premier chirurgien-chef, le Dr Olivier Monod (1904-2000). Alors que commence \u00e0 se d\u00e9velopper apr\u00e8s 1950 la m\u00e9decine n\u00e9onatale, nouveau champ de la m\u00e9decine p\u00e9diatrique, gr\u00e2ce \u00e0 la reconnaissance de la sp\u00e9cificit\u00e9 du nouveau-n\u00e9 tant du point de la physiologie, de la pathologie que de la th\u00e9rapeutique, O. Monod souhaite augmenter les op\u00e9rations de nourrissons pr\u00e9sentant des cardiopathies cong\u00e9nitales. Il cr\u00e9\u00e9 aussi une consultation externe de cardiologie infantile, assur\u00e9e par le Dr Odile Schweisguth (1913-2000), assistante du professeur R. Debr\u00e9 \u00e0 l\u2019h\u00f4pital des Enfants Malades et fondatrice du premier service de canc\u00e9rologie de l\u2019enfant \u00e0 l\u2019Institut du cancer de Paul Brousse \u00e0 Villejuif.<\/p>\n\n\n\n

L\u2019essor de la chirurgie des cardiopathies cong\u00e9nitales du nourrisson<\/h3>\n\n\n\n

La chirurgie des cardiopathies cong\u00e9nitales du nourrisson se d\u00e9veloppe surtout au d\u00e9but des ann\u00e9es 1970, gr\u00e2ce aux progr\u00e8s de l\u2019anesth\u00e9sie et de la r\u00e9animation du nouveau-n\u00e9. Dans le cas de l\u2019H\u00f4pital Marie-Lannelongue, la r\u00e9animation post-op\u00e9ratoire \u00e9tait alors assur\u00e9e par le service du professeur Gilbert Huault (1932-2013) de l\u2019h\u00f4pital Saint-Vincent-de-Paul. Ce dernier a fond\u00e9 en 1964 et dirig\u00e9 d\u2019abord dans le cadre du service du professeur St\u00e9phane Thieffry (1910-1990), la premi\u00e8re unit\u00e9 de r\u00e9animation p\u00e9diatrique de France (ventilation artificielle par intubation prolong\u00e9e, traitement des syndromes apn\u00e9iques, des suites op\u00e9ratoires des cardiopathies, des d\u00e9tresses respiratoires du nouveau-n\u00e9\u2026). D\u00e8s 1974, l\u2019h\u00f4pital Marie-Lannelongue, prend en charge totalement les jeunes malades gr\u00e2ce \u00e0 une unit\u00e9 de r\u00e9animation de 9 lits dirig\u00e9e par le Dr Jacqueline Bruniaux. Le service de R\u00e9animation nourrissons se d\u00e9veloppe encore avec l\u2019installation de l\u2019h\u00f4pital Marie-Lannelongue au Plessis Robinson (1977). Dix ans plus tard, un peu plus de 35 % des 40 lits de r\u00e9animation concerne l\u2019hospitalisation p\u00e9diatrique. Les techniques de l\u2019hypothermie profonde puis de l\u2019hypothermie g\u00e9n\u00e9ralis\u00e9e par la circulation extracorporelle (CEC) permettent \u00e0 l\u2019\u00e9quipe du service de cardiologie du professeur Jean-Paul Binet (1924-2008) de r\u00e9aliser de tr\u00e8s nombreuses interventions chirurgicales et d\u2019obtenir la plus grande s\u00e9rie mondiale de traitement chirurgical des anomalies des arcs aortiques chez l\u2019enfant, d\u2019avoir la plus grande exp\u00e9rience des emphys\u00e8mes lobaires g\u00e9ants du nourrissons et \u00e0 la fin des ann\u00e9es 1970, d\u2019avoir la ma\u00eetrise d\u2019une technique originale de traitement chirurgical de la T\u00e9tralogie de Fallot (enfants bleus).<\/p>\n\n\n\n

Au d\u00e9but des ann\u00e9es 1980, sous l\u2019impulsion de J.-P. Binet, la chirurgie du nouveau-n\u00e9 (moins d\u2019un mois et de moins de 5 kg), r\u00e9alis\u00e9e dans un cadre de semi-urgence, est en plein d\u00e9veloppement : coarctation aortique n\u00e9onatale ; traitement chirurgical en urgence des retours veineux pulmonaire anormaux totaux ; nouvelle technique chirurgicale concernant la correction anatomique des transpositions des gros vaisseaux d\u00e8s les premiers jours de la vie ; la r\u00e9paration compl\u00e8te des canaux atrio-ventriculaires (premi\u00e8re en 1959), est entreprise de plus en plus t\u00f4t dans la vie\u2026 De 1972 \u00e0 1982, avec 700 enfants op\u00e9r\u00e9s, le service de chirurgie cardio-vasculaire a la plus grande s\u00e9rie mondiale de fermeture des communications interventriculaires (premi\u00e8re r\u00e9ussite de fermeture d\u2019une CIV en 1957). Si au d\u00e9but des ann\u00e9es 1990, l\u2019H\u00f4pital Marie-Lannelongue compte 200 nourrissons op\u00e9r\u00e9s de transposition des gros vaisseaux \u00ab le switch \u00bb (premi\u00e8re correction anatomique en 1984) par le professeur Claude Planch\u00e9, ce qui constitue encore la plus grande s\u00e9rie mondiale, les ann\u00e9es 2000-2010 connaissent une moyenne annuelle de plus de 760 cardiopathies cong\u00e9nitales op\u00e9r\u00e9es dans le d\u00e9partement des cardiopathies cong\u00e9nitales avec une tr\u00e8s nette augmentation de l\u2019activit\u00e9 chirurgicale (de plus de 200 cas) \u00e0 la fin de la d\u00e9cennie.<\/p>\n\n\n\n

Dans le domaine des greffes, qui posent tout autant que la chirurgie classique des cardiopathies chez l\u2019enfant et le nourrisson, des probl\u00e8mes d\u2019\u00e9thiques, l\u2019H\u00f4pital Marie-Lannelongue s\u2019av\u00e8re \u00e9galement \u00e0 la pointe des r\u00e9alisations. En 1987, Claude Planch\u00e9 r\u00e9alise la premi\u00e8re greffe cardiaque (1\u00e8re europ\u00e9enne) sur un b\u00e9b\u00e9 de 6 jours. Un an plus tard, le professeur Philippe Dartevelle effectue la premi\u00e8re greffe fran\u00e7aise c\u0153ur-poumon chez un enfant atteint de mucoviscidose. Une quinzaine d\u2019ann\u00e9es plus tard, la chirurgie p\u00e9diatrique fait \u00e9tat d\u2019un bilan de 35 transplantations cardiaques chez des enfants, soit un peu moins de 20 % de l\u2019ensemble des greffes r\u00e9alis\u00e9es \u00e0 l\u2019H\u00f4pital Marie-Lannelongue, alors que se d\u00e9veloppent les techniques moins invasives de l\u2019activit\u00e9 du cath\u00e9t\u00e9risme interventionnel au sein du p\u00f4le des cardiopathies cong\u00e9nitales. Les r\u00e9sultats statistiques de la chirurgie p\u00e9diatrique et n\u00e9onatale, la qualit\u00e9 des \u00e9quipes, de l\u2019environnement multidisciplinaire p\u00e9diatrique, l\u2019association recherche clinique, recherche exp\u00e9rimentale et chirurgie, qui permettent aujourd\u2019hui de sauver de nombreux enfants porteurs d\u2019une cardiopathie cong\u00e9nitale, du f\u0153tus \u00e0 l\u2019\u00e2ge adulte, font de l\u2019H\u00f4pital Marie-Lannelongue, depuis plus de quarante ans, une r\u00e9f\u00e9rence mondiale dans ce domaine. La formation des \u00e9quipes internationales, qui en r\u00e9sulte tr\u00e8s directement, en fait foi.<\/p>\n","protected":false},"excerpt":{"rendered":"

Pour comprendre l\u2019histoire de l’H\u00f4pital Marie-Lannelongue et plus particuli\u00e8rement celle du P\u00f4le des Cardiopathies Cong\u00e9nitales, il faut remonter \u00e0 1885 et \u00e0 la cr\u00e9ation de la Ligue Fraternelle des Enfants de France pour venir en aide aux enfants malheureux, avec la cr\u00e9ation d\u2019un dispensaire. Une tradition : pr\u00e9vention de l\u2019enfance, soins des enfants et chirurgie […]<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":12459,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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