{"id":22699,"date":"2020-11-04T09:29:51","date_gmt":"2020-11-04T08:29:51","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?p=22699"},"modified":"2020-11-04T09:40:19","modified_gmt":"2020-11-04T08:40:19","slug":"le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/","title":{"rendered":"Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde"},"content":{"rendered":"\n<p>La thyro\u00efde est une glande situ\u00e9e \u00e0 l\u2019avant du cou qui produit les hormones thyro\u00efdiennes, dont notre corps a besoin pour se r\u00e9guler. Il est fr\u00e9quent que des nodules, petites tumeurs, apparaissent sur celle-ci. &nbsp;Ils sont la plupart du temps b\u00e9nins, mais ils peuvent grossir, voire \u00e9voluer en cancer. Il est alors n\u00e9cessaire d\u2019enlever une partie ou la totalit\u00e9 de la thyro\u00efde&nbsp;: c\u2019est la thyro\u00efdectomie.<br>La thyro\u00efdectomie peut engendrer trois types de complication : h\u00e9morragie, l\u00e9sion des parathyro\u00efdes, et l\u00e9sion des nerfs r\u00e9currents.<\/p>\n<h3>Parathyro\u00efdes et Fluobeam<\/h3>\n<p>L\u2019une des difficult\u00e9s auxquelles sont confront\u00e9s les chirurgiens lors d\u2019une thyro\u00efdectomie est la proximit\u00e9 des parathyro\u00efdes, des petites glandes associ\u00e9es \u00e0 la thyro\u00efde, qui r\u00e9gulent le taux de calcium dans le sang. Ces glandes sont de tr\u00e8s petite taille, quelques millim\u00e8tres \u00e0 peine, et peuvent donc \u00eatre difficiles \u00e0 identifier.<br>Or, la l\u00e9sion, voire l\u2019excision des parathyro\u00efdes entra\u00eene un d\u00e9ficit en calcium chez le patient et n\u00e9cessite la prise d\u2019un traitement m\u00e9dical, de mani\u00e8re transitoire, ou de mani\u00e8re permanente.<\/p>\n<p>Ce projet port\u00e9 par le Dr Gianluca Donatini s\u2019est construit autour de l\u2019outil Fluobeam, qui a tout d\u2019abord \u00e9t\u00e9 pr\u00eat\u00e9 au CHU pour une dur\u00e9e de 30 jours par la soci\u00e9t\u00e9 Fluoptics. La commission innovation du CHU a ensuite financ\u00e9 l\u2019achat de ce mat\u00e9riel, ce qui en fait le 5<sup>e<\/sup> centre en France dot\u00e9 du Fluobeam, et le seul en Nouvelle-Aquitaine.<\/p>\n<p>Ce dispositif d\u2019imagerie innovant fonctionne sur la base d\u2019une cam\u00e9ra \u00e0 infrarouges qui permet d\u2019identifier plus facilement les parathyro\u00efdes et leurs liaisons vasculaires. En effet, ces glandes, \u00e0 l\u2019instar de nombreuses structures biologiques, \u00e9mettent naturellement de la lumi\u00e8re infrarouge : c\u2019est l\u2019autofluorescence. La cam\u00e9ra du Fluobeam permet de visualiser ce ph\u00e9nom\u00e8ne pendant la chirurgie, et d\u2019\u00e9viter ainsi d\u2019endommager les parathyro\u00efdes.&nbsp;<\/p>\n<p>A ce jour, le Dr Donatini a eu l\u2019occasion d\u2019op\u00e9rer une trentaine de patients, et il a d\u00e9j\u00e0 pu observer une r\u00e9duction du taux de complications.<\/p>\n\n\n\n<figure class=\"wp-block-gallery columns-3 is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\"><ul class=\"blocks-gallery-grid\"><li class=\"blocks-gallery-item\"><figure><img decoding=\"async\" width=\"768\" height=\"1024\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1-768x1024.jpg\" alt=\"\" data-id=\"22700\" data-full-url=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1.jpg\" data-link=\"https:\/\/www.chu-poitiers.fr\/?attachment_id=22700\" class=\"wp-image-22700\" srcset=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1-768x1024.jpg 768w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1-225x300.jpg 225w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1-1152x1536.jpg 1152w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1-130x173.jpg 130w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1-550x733.jpg 550w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/1.jpg 1512w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img decoding=\"async\" width=\"814\" height=\"1024\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-814x1024.jpg\" alt=\"\" data-id=\"22701\" data-full-url=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2.jpg\" data-link=\"https:\/\/www.chu-poitiers.fr\/?attachment_id=22701\" class=\"wp-image-22701\" srcset=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-814x1024.jpg 814w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-239x300.jpg 239w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-768x966.jpg 768w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-1221x1536.jpg 1221w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-130x163.jpg 130w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2-550x692.jpg 550w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/2.jpg 1374w\" sizes=\"(max-width: 814px) 100vw, 814px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img decoding=\"async\" width=\"768\" height=\"1024\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3-768x1024.jpg\" alt=\"\" data-id=\"22702\" data-full-url=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3.jpg\" data-link=\"https:\/\/www.chu-poitiers.fr\/?attachment_id=22702\" class=\"wp-image-22702\" srcset=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3-768x1024.jpg 768w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3-225x300.jpg 225w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3-1152x1536.jpg 1152w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3-130x173.jpg 130w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3-550x733.jpg 550w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/3.jpg 1512w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/><\/figure><\/li><\/ul><\/figure>\n\n\n\n<h3>Cordes vocales et monitoring<\/h3>\n<p>La proximit\u00e9 de la thyro\u00efde avec les nerfs des cordes vocales, que l\u2019on appelle les nerfs r\u00e9currents, constitue une difficult\u00e9 suppl\u00e9mentaire lors de la chirurgie et peut \u00eatre la cause de complications, allant d\u2019une g\u00eane vocale temporaire \u00e0 un trouble respiratoire post-op\u00e9ratoire, n\u00e9cessitant une intervention m\u00e9dicale.<\/p>\n<p>Le CHU utilise le syst\u00e8me de neuromonitorage NIM 3.0 de la soci\u00e9t\u00e9 Medtronic, qui permet de rep\u00e9rer les nerfs r\u00e9currents pendant l\u2019op\u00e9ration et d\u2019\u00e9viter ainsi toute l\u00e9sion accidentelle. &nbsp;Cet outil a fait l\u2019objet d\u2019un second projet pr\u00e9sent\u00e9 par le Dr Donatini et \u00e9valu\u00e9 favorablement par la commission innovation du CHU de Poitiers, ainsi que d\u2019un projet dans le cadre du programme hospitalier de recherche clinique (PHRC) pr\u00e9sent\u00e9 en 2020.<\/p>\n<h3>Thyro\u00efdectomie et chirurgie ambulatoire<\/h3>\n<p>Gr\u00e2ce \u00e0 l\u2019engagement du CHU et \u00e0 son investissement dans du mat\u00e9riel perfectionn\u00e9 et innovant, le taux de complication lors des interventions de thyro\u00efdectomie, tant au niveau des parathyro\u00efdes qu\u2019au niveau des nerfs r\u00e9currents, a \u00e9t\u00e9 sensiblement r\u00e9duit, au point que le Dr Donatini a pour projet de demander l\u2019ouverture de cette chirurgie en ambulatoire, ce qui signifierait que les patients pourraient rentrer \u00e0 leur domicile dans la journ\u00e9e. Ce mode d\u2019hospitalisation permettrait \u00e0 la fois de baisser les co\u00fbts d\u2019hospitalisation, d\u2019augmenter le confort du patient qui pourra rentrer dormir \u00e0 son domicile, et de limiter les risques d\u2019<a href=\"https:\/\/www.facebook.com\/251846181558030\/videos\/710543229873690\"><u>infections nosocomiales<\/u><\/a>. &nbsp;<br>La chirurgie ambulatoire serait toutefois r\u00e9serv\u00e9e aux patients jeunes, dont la thyro\u00efde est de petite taille.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Chaque ann\u00e9e, en France, environ 50\u00a0000 patients subissent une ablation de la thyro\u00efde (thyro\u00efdectomie). Au CHU de Poitiers, cela repr\u00e9sente environ\u2026","protected":false},"author":12,"featured_media":22705,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-22699","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde - Site du CHU de Poitiers<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde\" \/>\n<meta property=\"og:description\" content=\"Chaque ann\u00e9e, en France, environ 50\u00a0000 patients subissent une ablation de la thyro\u00efde (thyro\u00efdectomie). Au CHU de Poitiers, cela repr\u00e9sente environ 400 op\u00e9rations par an. Aujourd\u2019hui, le CHU fait partie des leaders fran\u00e7ais et europ\u00e9ens en termes d\u2019innovation et de qualit\u00e9 chirurgicale dans le domaine de la chirurgie endocrinienne. Le CHU de Poitiers a d\u2019ailleurs \u00e9t\u00e9 class\u00e9 en 8e position parmi les h\u00f4pitaux fran\u00e7ais par Le Point dans la cat\u00e9gorie du traitement des cancers de la thyro\u00efde. Bien qu\u2019assez courante, cette chirurgie peut, dans certains cas, entra\u00eener des complications. C\u2019est dans ce contexte qu\u2019en 2020, le Dr Gianluca Donatini, chirurgien visc\u00e9ral au sein du service de chirurgie digestive du Pr Jean-Pierre Richer et de l\u2019unit\u00e9 de chirurgie endocrinienne du Pr Jean-Louis Kraimps, a pr\u00e9sent\u00e9 \u00e0 la commission innovation du CHU de Poitiers un projet d\u2019\u00e9tude clinique ayant pour objectif de pr\u00e9venir les complications et de diminuer le temps d\u2019hospitalisation des patients op\u00e9r\u00e9s de la thyro\u00efde.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/\" \/>\n<meta property=\"og:site_name\" content=\"Site du CHU de Poitiers\" \/>\n<meta property=\"article:published_time\" content=\"2020-11-04T08:29:51+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-11-04T08:40:19+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/4.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1512\" \/>\n\t<meta property=\"og:image:height\" content=\"2016\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Morgane Pr\u00e9maud\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Morgane Pr\u00e9maud\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"NewsArticle\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/en\\\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/en\\\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\\\/\"},\"author\":{\"name\":\"Morgane Pr\u00e9maud\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/#\\\/schema\\\/person\\\/c3b1c950cff7a774b33177b5cdabb2cb\"},\"headline\":\"Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde\",\"datePublished\":\"2020-11-04T08:29:51+00:00\",\"dateModified\":\"2020-11-04T08:40:19+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/en\\\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\\\/\"},\"wordCount\":662,\"publisher\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/en\\\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/wp-content\\\/uploads\\\/2020\\\/11\\\/4.jpg\",\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/en\\\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\\\/\",\"url\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/en\\\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\\\/\",\"name\":\"Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde - 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Au CHU de Poitiers, cela repr\u00e9sente environ 400 op\u00e9rations par an. Aujourd\u2019hui, le CHU fait partie des leaders fran\u00e7ais et europ\u00e9ens en termes d\u2019innovation et de qualit\u00e9 chirurgicale dans le domaine de la chirurgie endocrinienne. Le CHU de Poitiers a d\u2019ailleurs \u00e9t\u00e9 class\u00e9 en 8e position parmi les h\u00f4pitaux fran\u00e7ais par Le Point dans la cat\u00e9gorie du traitement des cancers de la thyro\u00efde. Bien qu\u2019assez courante, cette chirurgie peut, dans certains cas, entra\u00eener des complications. C\u2019est dans ce contexte qu\u2019en 2020, le Dr Gianluca Donatini, chirurgien visc\u00e9ral au sein du service de chirurgie digestive du Pr Jean-Pierre Richer et de l\u2019unit\u00e9 de chirurgie endocrinienne du Pr Jean-Louis Kraimps, a pr\u00e9sent\u00e9 \u00e0 la commission innovation du CHU de Poitiers un projet d\u2019\u00e9tude clinique ayant pour objectif de pr\u00e9venir les complications et de diminuer le temps d\u2019hospitalisation des patients op\u00e9r\u00e9s de la thyro\u00efde.","og_url":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/","og_site_name":"Site du CHU de Poitiers","article_published_time":"2020-11-04T08:29:51+00:00","article_modified_time":"2020-11-04T08:40:19+00:00","og_image":[{"width":1512,"height":2016,"url":"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/4.jpg","type":"image\/jpeg"}],"author":"Morgane Pr\u00e9maud","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Morgane Pr\u00e9maud","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"NewsArticle","@id":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/#article","isPartOf":{"@id":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/"},"author":{"name":"Morgane Pr\u00e9maud","@id":"https:\/\/www.chu-poitiers.fr\/#\/schema\/person\/c3b1c950cff7a774b33177b5cdabb2cb"},"headline":"Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde","datePublished":"2020-11-04T08:29:51+00:00","dateModified":"2020-11-04T08:40:19+00:00","mainEntityOfPage":{"@id":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/"},"wordCount":662,"publisher":{"@id":"https:\/\/www.chu-poitiers.fr\/#organization"},"image":{"@id":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/#primaryimage"},"thumbnailUrl":"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2020\/11\/4.jpg","inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/","url":"https:\/\/www.chu-poitiers.fr\/en\/le-chu-de-poitiers-a-la-pointe-dans-le-traitement-chirurgical-de-la-thyroide\/","name":"Le CHU de Poitiers \u00e0 la pointe dans le traitement chirurgical de la thyro\u00efde - 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