3 years ago

Stratégie chirurgicale : quelles nouvelles techniques ? La chirurgie minimalement invasive (RATS/VATS). Les exérèses d’épargne parenchymateuse. Les parcours de soin accélérés

L. Gust, G. Brioude, N. Ghourchidian, S. Dizier, A. Charvet, D. Trousse, X.b. D’journo, C. Doddoli, M. Leone, P.-a. Thomas

Publication date: September 2017

Source: Revue des Maladies Respiratoires Actualités, Volume 9, Issue 2

Author(s): L. Gust, G. Brioude, N. Ghourchidian, S. Dizier, A. Charvet, D. Trousse, X.B. D’journo, C. Doddoli, M. Leone, P.-A. Thomas

Résumé

La chirurgie thoracique a bénéficié de nombreuses innovations techniques au cours des dernières décennies. En parallèle les programmes de dépistage permettent de diagnostiquer des cancers bronchiques primitifs à des stades plus précoces. Les pratiques chirurgicales se sont donc modifiées d’une part par la généralisation des voies mini-invasives, d’autre part par l’apparition des résections anatomiques infralobaires (segmentectomies) que l’on pourraient qualifier de « chirurgie de précision » qui apparaissent comme des alternatives valables à la lobectomie dans des situations définies, et enfin par la mise en place de parcours de soins accélérés et personnalisés, parfois même ambulatoires. L’objet de cette revue, sera de détailler ces aspects modernes de la chirurgie thoracique au travers de ces trois points, intrinsèquement liés les uns aux autres.

Abstract

During the last decades, innovations and new technologies allowed improvements in the field of thoracic surgery. The implementation of screening programs also lead to the diagnosis of lung cancers of smaller size and earlier stage. Surgical practice was thus modified. On one hand, minimally invasive techniques are more and more used. On the other hand, sub-lobar resections (segmentectomies), which could be adressed as precision surgeries, are becoming valid alternatives to lobectomies in specific situations. And finally, clinical pathways including enhanced recovery after surgery programs are created.

The aim of this review will be to describe in detail those three aspects of modern surgery, that are closely interlinked.

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