Oncologie

, Volume 15, Issue 3–4, pp 155–159 | Cite as

Prise en charge chirurgicale de l’adénocarcinome gastrique

Mise au point / Update
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Résumé

La chirurgie est le principal traitement de l’adénocarcinome gastrique. La qualité de la chirurgie dépend, d’une part, de la qualité de la résection et du respect des règles carcinologiques, d’autre part, des mesures permettant d’optimiser la prise en charge périopératoire. L’immunonutrition participe à l’optimisation préopératoire. L’optimisation peropératoire confiée aux anesthésistes s’attache à maintenir la volémie dans les limites permettant le meilleur transport de l’oxygène possible. La ventilation artificielle peropératoire limite, elle, aumaximum, le barotraumatisme pulmonaire. Les rares indications de chirurgie des formes métastatiques doivent être connues. La voie d’abord coelioscopique nécessiterait, pour s’imposer, une étude prospective comparative de phase III.

Mots clés

Critères qualité Chirurgie Adénocarcinome gastrique 

Surgical support for gastric adenocarcinoma

Abstract

Surgery is the main treatment for gastric adenocarcinoma. Surgical quality criteria depend on one hand on the resection quality and compliance of carcinologic rules, and on the other hand on measures allowing perioperative care optimization. Immunological nutrition is part of preoperative optimization. Anaesthesiologists have to maintain volemia in the limits allowing the best oxygen blood transport. Artificial ventilation has to limit asmuch as possible the pulmonary barotraumatism. Surgeons must know the rare indications of metastases resection. For becoming a recommendation, laparoscopic gastrectomy would require a large multicentric clinical trial.

Keywords

Quality criteria Surgery Gastric adenocarcinoma 

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Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  1. 1.Service de chirurgie digestiveCHU EstaingClermont-FerrandFrance
  2. 2.Service d’anesthésie-réanimationCHU EstaingClermont-FerrandFrance

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