{"id":18539,"date":"2020-01-27T14:18:44","date_gmt":"2020-01-27T13:18:44","guid":{"rendered":"https:\/\/devhml.givememore.net\/specialites\/greffes-2\/"},"modified":"2022-02-10T15:54:59","modified_gmt":"2022-02-10T14:54:59","slug":"chirurgie-tumeurs-envahissant-defile-cervicothoracique","status":"publish","type":"service","link":"https:\/\/devhml.givememore.net\/specialites\/chirurgie-thoracique\/interventions\/chirurgie-tumeurs-envahissant-defile-cervicothoracique\/","title":{"rendered":"Chirurgie des tumeurs envahissant le d\u00e9fil\u00e9 cervicothoracique"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Les tumeurs malignes du poumon, localis\u00e9es au niveau de l\u2019apex pari\u00e9to-pulmonaire, ou celles d\u00e9velopp\u00e9es \u00e0 partir de la paroi thoracique au niveau de la jonction cervico-thoracique, ont pour particularit\u00e9 d\u2019envahir les structures vasculaires et nerveuses de cette jonction cervico-thoracique dont la complexit\u00e9 anatomique est connue.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nous avons d\u00e9crit, il y a 20 ans une approche originale de ces tumeurs en r\u00e9s\u00e9quant la moiti\u00e9 interne de la clavicule et en op\u00e9rant ces patients par voie ant\u00e9rieure contrairement \u00e0 ce qui est fait habituellement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Depuis, cette nouvelle approche s\u2019est progressivement r\u00e9pandue en Europe et aux USA faisant r\u00e9guli\u00e8rement l\u2019objet d\u2019articles, de mise au point et de discussions dans les diff\u00e9rents congr\u00e8s internationaux de chirurgie thoracique.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nous avons actuellement op\u00e9r\u00e9 par cette voie plus de 130 cancers du poumon responsables de syndromes de Pancoast et Tobias et 80 autres types de tumeurs localis\u00e9es au d\u00e9fil\u00e9 cervicothoracique.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Il s\u2019agit d\u2019interventions complexes comprenant la r\u00e9section de la paroi thoracique apicale, la r\u00e9section et le remplacement des vaisseaux sous claviers, l\u2019ex\u00e9r\u00e8se du lobe sup\u00e9rieur du poumon et un curage ganglionnaire m\u00e9diastinal. Ces interventions sont particuli\u00e8rement longues et difficiles lorsque l\u2019ex\u00e9r\u00e8se doit comporter une h\u00e9mivertebrectomie des trois ou quatre premi\u00e8res vert\u00e8bres thoraciques associ\u00e9e \u00e0 une ost\u00e9osynth\u00e8se rachidienne.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les tumeurs malignes du poumon, localis\u00e9es au niveau de l\u2019apex pari\u00e9to-pulmonaire, ou celles d\u00e9velopp\u00e9es \u00e0 partir de la paroi thoracique au niveau de la jonction cervico-thoracique, ont pour particularit\u00e9 d\u2019envahir les structures vasculaires et nerveuses de cette jonction cervico-thoracique dont la complexit\u00e9 anatomique est connue. Nous avons d\u00e9crit, il y a 20 ans une approche [&hellip;]<\/p>\n","protected":false},"author":22,"featured_media":0,"parent":16234,"menu_order":5,"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-18539","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 14 h 18 min","modified":"Mise \u00e0 jour le 10 f\u00e9vrier 2022 15 h 54 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\/18539","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\/18539\/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=18539"}],"wp:term":[{"taxonomy":"etablissements","embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/etablissements?post=18539"},{"taxonomy":"services","embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/services?post=18539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}