{"id":3536,"date":"2014-11-27T11:14:18","date_gmt":"2014-11-27T10:14:18","guid":{"rendered":"http:\/\/chu-poitiers.ovh\/?p=3536"},"modified":"2015-09-16T14:38:53","modified_gmt":"2015-09-16T12:38:53","slug":"question-a-christophe-jayle-chirurgien-cardio-thoracique","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/question-a-christophe-jayle-chirurgien-cardio-thoracique\/","title":{"rendered":"Question \u00e0\u2026 Christophe Jayle, chirurgien cardio-thoracique"},"content":{"rendered":"

En quoi consiste ce projet de recherche m\u00e9dico-\u00e9conomique ?
\n<\/strong>Ce projet constitue \u00e0 \u00e9tudier l\u2019int\u00e9r\u00eat m\u00e9dico-\u00e9conomique d\u2019une technique de traitement du volet thoracique (portion de la paroi thoracique compl\u00e8tement ou partiellement d\u00e9solidaris\u00e9e du reste de la cage thoracique \u00e0 la suite d’une fracture multiple des c\u00f4tes). Il permettra de d\u00e9terminer l\u2019impact global de la prise en charge des volets thoraciques en termes de sant\u00e9 publique, notamment en mati\u00e8re de dur\u00e9e et de co\u00fbt pour l\u2019h\u00f4pital et de qualit\u00e9 de vie et de douleur pour le patient. Si l\u2019\u00e9tude porte ses fruits, l\u2019op\u00e9ration sera prise en charge par la S\u00e9curit\u00e9 sociale, ce qui n\u2019est pas le cas actuellement.<\/p>\n

Comment les victimes de volet thoracique sont-elles prises en charge actuellement ?<\/strong>
\nQuand un patient arrive avec un volet thoracique, souvent provoqu\u00e9 par un accident de voiture ou de moto ou bien une chute de cheval ou d\u2019un toit, il y a deux solutions : soit on laisse les fractures se remettre d\u2019elles-m\u00eames, soit on op\u00e8re. L\u2019op\u00e9ration constitue \u00e0 rapprocher les morceaux de c\u00f4tes cass\u00e9es gr\u00e2ce \u00e0 des agrafes pour r\u00e9duire les fractures. Il y a trente ans, une technique avec des agrafes en acier avait \u00e9t\u00e9 test\u00e9e, mais l\u2019acier cassait et la m\u00e9thode avait \u00e9t\u00e9 abandonn\u00e9e. Depuis cinq ans, nous utilisons des agrafes en titane, un mat\u00e9riau tr\u00e8s r\u00e9sistant mais aussi tr\u00e8s mall\u00e9able, qui s\u2019adapte \u00e0 la morphologie incurv\u00e9e des c\u00f4tes.<\/p>\n

\"Agrafe<\/a>
Agrafe en titane<\/figcaption><\/figure>\n

Quels sont les avantages de l\u2019op\u00e9ration ?<\/strong>
\nPendant l\u2019\u00e9tude pilote, sur un petit nombre de patients, nous avons constat\u00e9 que l\u2019op\u00e9ration permettait de diminuer de trois jours le temps pass\u00e9 en r\u00e9animation et de r\u00e9duire de dix jours la dur\u00e9e d\u2019hospitalisation. De plus, les patients semblent moins souffrir, la fonction respiratoire est pr\u00e9serv\u00e9e et le gain esth\u00e9tique est important. Nous avons donc sollicit\u00e9 la Direction g\u00e9n\u00e9rale de l\u2019offre de soins pour obtenir le financement d\u2019une \u00e9tude de grande ampleur.<\/p>\n

Comment va se d\u00e9rouler cette \u00e9tude ?<\/strong>
\nElle durera deux ans \u00e0 partir du 1er<\/sup> mai 2015 et devra int\u00e9grer 310\u00a0patients (155\u00a0op\u00e9r\u00e9s et 155\u00a0non op\u00e9r\u00e9s) pris en charge dans quinze CHU que nous allons choisir parmi les vingt-deux qui sont pr\u00eats \u00e0 participer \u00e0 l\u2019\u00e9tude. Le choix sera bas\u00e9 en partie sur le fait que l\u2019\u00e9quipe de chirurgie et celle d\u2019anesth\u00e9sie-r\u00e9animation soient soud\u00e9es, comme c\u2019est le cas au CHU entre notre service et celui du Pr Olivier Mimoz, qui soutient ce projet. Ce sera la premi\u00e8re \u00e9tude randomis\u00e9e (les patients sont al\u00e9atoirement r\u00e9partis) de cette ampleur dans le monde sur ce sujet. Le co\u00fbt du projet est \u00e9valu\u00e9 \u00e0 7\u00a0600\u00a0euros par patient, soit 2\u00a0360\u00a0000 euros en tout. Il faut savoir que le co\u00fbt des agrafes en titane est d\u00e9j\u00e0 compris entre 2\u00a0000 \u00e0 4\u00a0000 par patient. Actuellement, le co\u00fbt de l\u2019intervention des patients op\u00e9r\u00e9s pour un volet thoracique au CHU de Poitiers, soit une vingtaine par an, est pris en charge par le CHU via sa cellule innovation. Cela permet d\u2019ailleurs \u00e0 l\u2019\u00e9tablissement d\u2019\u00eatre un pr\u00e9curseur de cette technique en France. Ensuite, il faut aussi payer le logiciel, le personnel, ainsi que les consultations et les examens sp\u00e9cifiques \u00e0 l\u2019\u00e9tude.<\/p>\n

\"Volet
Avant<\/figcaption><\/figure>\n
\"Volet<\/a>
Apr\u00e8s<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

Le professeur Christophe Jayle a fait ses \u00e9tudes \u00e0 Lyon avant de rejoindre le CHU Poitiers pour y effectuer son internat de chirurgie et un DEA en\u2026","protected":false},"author":1,"featured_media":3541,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[30,1],"tags":[],"class_list":["post-3536","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiologie","category-uncategorized"],"acf":[],"yoast_head":"\nQuestion \u00e0\u2026 Christophe Jayle, chirurgien cardio-thoracique - 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\/question-a-christophe-jayle-chirurgien-cardio-thoracique\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Question \u00e0\u2026 Christophe Jayle, chirurgien cardio-thoracique - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"Le professeur Christophe Jayle a fait ses \u00e9tudes \u00e0 Lyon avant de rejoindre le CHU Poitiers pour y effectuer son internat de chirurgie et un DEA en sciences chirurgicales \u00e0 l\u2019Inserm 1082, au cot\u00e9 du Pr Thierry Hauet. 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