{"id":7200,"date":"2015-05-12T10:00:39","date_gmt":"2015-05-12T08:00:39","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?p=7200"},"modified":"2015-09-16T14:22:01","modified_gmt":"2015-09-16T12:22:01","slug":"chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\/","title":{"rendered":"Chirurgie gyn\u00e9cologique et digestive : ensemble pour traiter la carcinose p\u00e9riton\u00e9ale"},"content":{"rendered":"<p>\u00ab Jusque-l\u00e0, les gens porteurs de cancer avec carcinose p\u00e9riton\u00e9ale d\u00e9c\u00e9daient tr\u00e8s rapidement sans espoir de gu\u00e9rison ou de stabilisation de la maladie \u00bb, assure Michel Carretier, chef du service de chirurgie visc\u00e9rale. Depuis une dizaine d\u2019ann\u00e9es, les progr\u00e8s de la r\u00e9animation p\u00e9ri-op\u00e9ratoire, qui autorise des chirurgies complexes, et de la chimioth\u00e9rapie ont permis d\u2019am\u00e9liorer la survie de ces cancers. \u00ab Aujourd\u2019hui, la combinaison chirurgie\/chimioth\u00e9rapie permet de stabiliser, voire de gu\u00e9rir certains de ces cancers \u00bb, affirme Michel Carretier. Une combinaison particuli\u00e8rement efficace pour les carcinoses p\u00e9riton\u00e9ales du cancer des ovaires et digestifs (cancer du c\u00f4lon, du rectum, de l\u2019estomac). Concernant les cancers digestifs, le traitement se base tr\u00e8s souvent sur une chimioth\u00e9rapie pr\u00e9op\u00e9ratoire, une intervention chirurgicale et une chimioth\u00e9rapie postop\u00e9ratoire. En revanche, pour la gyn\u00e9cologie, la chirurgie doit \u00eatre premi\u00e8re, et dans ce cas-l\u00e0 aussi suivie d\u2019une chimioth\u00e9rapie.<\/p>\n<p>\u00ab En cas de carcinose p\u00e9riton\u00e9ale, tout l\u2019enjeu de ces chirurgies est de trouver une solution th\u00e9rapeutique qui permette \u00e0 la fois d\u2019enlever ce qui doit l\u2019\u00eatre pour soigner la maladie tout en conservant et pr\u00e9servant au maximum les organes vitaux \u00bb, explique le docteur C\u00e9dric Nadeau, chirurgien onco-gyn\u00e9cologique au centre universitaire de Poitiers.<\/p>\n<p>\u00ab Concernant les cancers digestifs, l\u2019acte chirurgical consiste \u00e0 enlever tous les nodules de la cavit\u00e9 abdominale et \u00e0 terminer l\u2019intervention par la mise en place, dans l\u2019abdomen du patient, d\u2019un liquide contenant des doses de chimioth\u00e9rapie vingt fois sup\u00e9rieures \u00e0 celles que l\u2019on injecte par voie sanguine \u00bb, pr\u00e9cise Michel Carretier. Il s\u2019agit de la chimioth\u00e9rapie hyperthermique intra-p\u00e9riton\u00e9ale (Chip).<\/p>\n<p><strong>Le CHU comme centre de recours r\u00e9gional<\/strong><br \/>\nPour r\u00e9pondre \u00e0 cet enjeu th\u00e9rapeutique et du fait des comp\u00e9tences en chirurgie gyn\u00e9cologique et digestive au Centre hospitalier universitaire de Poitiers, il a \u00e9t\u00e9 d\u00e9cid\u00e9 de mettre en place, en janvier 2014, une r\u00e9union de concertation pluridisciplinaire sur les carcinoses p\u00e9riton\u00e9ales qui r\u00e9unit la chirurgie des cancers gyn\u00e9cologiques, digestifs, les canc\u00e9rologues gyn\u00e9cologiques et digestifs. Ces r\u00e9unions se d\u00e9roulent tous les lundis au CHU, \u00ab un moment pendant lequel nous discutons de tous les dossiers \u00bb, explique C\u00e9dric Nadeau.<\/p>\n<p>Les fiches de concertation pluridisciplinaire peuvent \u00eatre remplies sur le site du r\u00e9seau r\u00e9gional de canc\u00e9rologie Onco-Poitou-Charentes. \u00ab Nous les examinons toutes. Ce qui est important, c\u2019est de savoir que tous les m\u00e9decins de la r\u00e9gion peuvent nous adresser un dossier. Apr\u00e8s examen, le m\u00e9decin peut obtenir un rendez-vous avec un chirurgien gyn\u00e9co du CHU, en cas de cancer gyn\u00e9cologique, ou avec un oncologue digestif en cas de cancer digestif, s\u2019il le souhaite. Nous organisons ensuite toute la prise en charge, si n\u00e9cessaire \u00bb, assure C\u00e9dric Nadeau.<\/p>\n<p>Une prise en charge qui demande la mise \u00e0 disposition d\u2019un service de r\u00e9animation et de soins continus tr\u00e8s performants pour une surveillance intensive.<\/p>\n<p>Depuis la mise en place de cette r\u00e9union de concertation, le recrutement de ce type de patients est en augmentation au CHU de Poitiers. \u00ab Il est important que tous les patients de la r\u00e9gion qui en ont besoin soient dirig\u00e9s vers cette r\u00e9union de concertation et que les dossiers soient discut\u00e9s. Ainsi le CHU tient-il son r\u00f4le de centre de recours r\u00e9gional dans le traitement de la prise en charge de la carcinose p\u00e9riton\u00e9ale \u00bb, insiste Michel Carretier.<\/p>\n<figure id=\"attachment_7203\" aria-describedby=\"caption-attachment-7203\" style=\"width: 250px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-tdm-carcinose-coupole.jpg\"><img decoding=\"async\" class=\"zoom filet wp-image-7203\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-tdm-carcinose-coupole.jpg\" alt=\"Images TDM de carcinose\" width=\"250\" height=\"250\" srcset=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-tdm-carcinose-coupole.jpg 512w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-tdm-carcinose-coupole-150x150.jpg 150w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-tdm-carcinose-coupole-300x300.jpg 300w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-tdm-carcinose-coupole-130x130.jpg 130w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><figcaption id=\"caption-attachment-7203\" class=\"wp-caption-text\">Images TDM de carcinose<\/figcaption><\/figure>\n<figure id=\"attachment_7202\" aria-describedby=\"caption-attachment-7202\" style=\"width: 250px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-TDM-carcinose-IIIc.jpg\"><img decoding=\"async\" class=\"zoom filet wp-image-7202\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-TDM-carcinose-IIIc.jpg\" alt=\"Images TDM de carcinose\" width=\"250\" height=\"250\" srcset=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-TDM-carcinose-IIIc.jpg 512w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-TDM-carcinose-IIIc-150x150.jpg 150w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-TDM-carcinose-IIIc-300x300.jpg 300w, https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/image-TDM-carcinose-IIIc-130x130.jpg 130w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><figcaption id=\"caption-attachment-7202\" class=\"wp-caption-text\">Images TDM de carcinose<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Dans le traitement des cancers gyn\u00e9cologiques et digestifs, la combinaison chirurgie et chimioth\u00e9rapie est d\u00e9terminante en cas de carcinose p\u00e9riton\u00e9ale.\u2026","protected":false},"author":1,"featured_media":7204,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[42,45,1],"tags":[],"class_list":["post-7200","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-chirurgie-viscerale","category-gynecologie-obstetrique","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>Chirurgie gyn\u00e9cologique et digestive : ensemble pour traiter la carcinose p\u00e9riton\u00e9ale - 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\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Chirurgie gyn\u00e9cologique et digestive : ensemble pour traiter la carcinose p\u00e9riton\u00e9ale - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"Dans le traitement des cancers gyn\u00e9cologiques et digestifs, la combinaison chirurgie et chimioth\u00e9rapie est d\u00e9terminante en cas de carcinose p\u00e9riton\u00e9ale. Au Centre hospitalier universitaire de Poitiers, les services de chirurgie visc\u00e9rale, de gyn\u00e9cologie et d\u2019oncologie m\u00e9dicale allient leurs comp\u00e9tences pour traiter au mieux ces pathologies lourdes.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.chu-poitiers.fr\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\/\" \/>\n<meta property=\"og:site_name\" content=\"Site du CHU de Poitiers\" \/>\n<meta property=\"article:published_time\" content=\"2015-05-12T08:00:39+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2015-09-16T12:22:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2015\/05\/reunion_carcinome.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1800\" \/>\n\t<meta property=\"og:image:height\" content=\"1196\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"ChuPoitiers\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"ChuPoitiers\" \/>\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\\\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\\\/\"},\"author\":{\"name\":\"ChuPoitiers\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/#\\\/schema\\\/person\\\/08e92cc802383a84a4efc3b8a6a6658c\"},\"headline\":\"Chirurgie gyn\u00e9cologique et digestive : ensemble pour traiter la carcinose p\u00e9riton\u00e9ale\",\"datePublished\":\"2015-05-12T08:00:39+00:00\",\"dateModified\":\"2015-09-16T12:22:01+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\\\/\"},\"wordCount\":640,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/wp-content\\\/uploads\\\/2015\\\/05\\\/reunion_carcinome.jpg\",\"articleSection\":[\"Chirurgie visc\u00e9rale\",\"Gyn\u00e9cologie-obst\u00e9trique\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\\\/\",\"url\":\"https:\\\/\\\/www.chu-poitiers.fr\\\/chirurgie-gynecologique-et-digestive-ensemble-pour-traiter-la-carcinose-peritoneale\\\/\",\"name\":\"Chirurgie gyn\u00e9cologique et digestive : ensemble pour traiter la carcinose p\u00e9riton\u00e9ale - 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