{"id":18503,"date":"2020-01-27T10:58:25","date_gmt":"2020-01-27T09:58:25","guid":{"rendered":"https:\/\/devhml.givememore.net\/specialites\/chirurgie-thoracique\/les-fistules-oesotracheales\/"},"modified":"2022-02-10T15:52:17","modified_gmt":"2022-02-10T14:52:17","slug":"les-fistules-oesotracheales","status":"publish","type":"service","link":"https:\/\/devhml.givememore.net\/specialites\/chirurgie-thoracique\/interventions\/les-fistules-oesotracheales\/","title":{"rendered":"Les fistules \u0153sotrach\u00e9ales"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Les fistules \u0153sotrach\u00e9ales, apparaissant apr\u00e8s r\u00e9animation respiratoire par ventilation assist\u00e9e, sont de traitement difficile.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Peu de centres ont une exp\u00e9rience de cette chirurgie dont la technique id\u00e9ale est la r\u00e9alisation d\u2019une longue r\u00e9section anastomose de trach\u00e9e associ\u00e9e \u00e0 une plastie directe de l\u2019\u0153sophage \u00e9vitant ainsi les interventions multiples et les d\u00e9rivations \u0153sophagiennes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nous avons fait en ao\u00fbt 2004 en collaboration avec les plasticiens de l\u2019IGR, la premi\u00e8re cure au monde d\u2019une fistule oesotrach\u00e9ale \u00e9tendue \u00e0 toute la trach\u00e9e par un lambeau libre fasciocutan\u00e9 pris sur l\u2019avant bras avec r\u00e9implantation du p\u00e9dicule art\u00e9riel et veineux sur les vaisseaux du cou. Cette intervention originale d\u00e9montre l\u2019int\u00e9r\u00eat de travailler avec d\u2019autres \u00e9quipes et renforce nos liens avec les h\u00f4pitaux de notre CHU notamment l\u2019IGR.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">La pathologie \u0153sophagienne vue dans notre service induit une quinzaine d\u2019interventions par an \u00e0 type de cure de hernie diaphragmatique volumineuse associ\u00e9e ou non \u00e0 reflux gastro-\u0153sophagien, d\u2019ex\u00e9r\u00e8se de tumeur de l\u2019\u0153sophage b\u00e9nigne ou maligne et de plaie et rupture de l\u2019\u0153sophage avec pyothorax qui ne sont pas trait\u00e9es dans les services de chirurgie digestive habitu\u00e9s \u00e0 la chirurgie de l\u2019\u0153sophage.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cette chirurgie \u0153sophagienne dans des centres sp\u00e9cialis\u00e9s de chirurgie thoracique comme l&rsquo;H\u00f4pital Marie-Lannelongue a l\u2019avantage d\u2019\u00eatre faite avec une morbidit\u00e9 et mortalit\u00e9 faibles du fait de la parfaite connaissance de la chirurgie thoracique et de ses suites op\u00e9ratoires.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les fistules \u0153sotrach\u00e9ales, apparaissant apr\u00e8s r\u00e9animation respiratoire par ventilation assist\u00e9e, sont de traitement difficile. Peu de centres ont une exp\u00e9rience de cette chirurgie dont la technique id\u00e9ale est la r\u00e9alisation d\u2019une longue r\u00e9section anastomose de trach\u00e9e associ\u00e9e \u00e0 une plastie directe de l\u2019\u0153sophage \u00e9vitant ainsi les interventions multiples et les d\u00e9rivations \u0153sophagiennes. Nous avons fait [&hellip;]<\/p>\n","protected":false},"author":22,"featured_media":0,"parent":16234,"menu_order":4,"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 center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"etablissements":[],"services":[],"class_list":["post-18503","service","type-service","status-publish","hentry"],"acf":[],"featured_img":false,"coauthors":[],"author_meta":{"author_link":"https:\/\/devhml.givememore.net\/author\/charlotte-gmm\/","display_name":"Charlotte"},"relative_dates":{"created":"Publi\u00e9 6 ans il y a","modified":"Mis \u00e0 jour 4 ans il y a"},"absolute_dates":{"created":"Publi\u00e9 le 27 janvier 2020","modified":"Mise \u00e0 jour le 10 f\u00e9vrier 2022"},"absolute_dates_time":{"created":"Publi\u00e9 le 27 janvier 2020 10 h 58 min","modified":"Mise \u00e0 jour le 10 f\u00e9vrier 2022 15 h 52 min"},"featured_img_caption":"","tax_additional":{"etablissements":{"linked":[],"unlinked":[],"slug":"etablissements","name":"\u00c9tablissements"},"services":{"linked":[],"unlinked":[],"slug":"services","name":"Services"}},"series_order":"","_links":{"self":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/18503","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service"}],"about":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/types\/service"}],"version-history":[{"count":0,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/18503\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/16234"}],"wp:attachment":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/media?parent=18503"}],"wp:term":[{"taxonomy":"etablissements","embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/etablissements?post=18503"},{"taxonomy":"services","embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/services?post=18503"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}