Introduction La modification du regard portésur l’objet«soin»affecte les pratiques de soin,dans une réflexion non plus uniquement centrée sur le remède,sur le soin en tant que«cure&...Introduction La modification du regard portésur l’objet«soin»affecte les pratiques de soin,dans une réflexion non plus uniquement centrée sur le remède,sur le soin en tant que«cure»,mais sur«la façon dont on donne le soin»[1]au sens oùWinnicott entend le《care-cure》[2];favorisant ainsi le développement de pratiques de soin innovantes,portée par une réflexion collective et pluridisciplinaire autour des patients.Si le soin en oncologie ne peut plus se penser ni se pratiquer en dehors d’une rencontre pluridisciplinaire autour du patient,il en va de même pour la recherche dans le domaine du cancer.展开更多
The Sino-French 2012 Conference in Thoracic Oncology, held November 17-18, 2012, was hosted by the Department of Thoracic Surgery at Sun Yat-sen University Cancer Center and organized in collaboration with two prestig...The Sino-French 2012 Conference in Thoracic Oncology, held November 17-18, 2012, was hosted by the Department of Thoracic Surgery at Sun Yat-sen University Cancer Center and organized in collaboration with two prestigious French hospitals: Institute Gustave Roussy and Marie Lannelongue Hospital. The conference was established by leading experts from China and France to serve as an international academic platform for sharing novel findings in basic research and valuable clinical practice experiences. Hot topics including innovation in surgical techniques, diagnosis and staging of early-stage lung cancer, minimally invasive surgery, multidisciplinary treatment of lung cancer, and progress in radiotherapy for lung cancer were explored. Highlights of the conference presentations are summarized in this report.展开更多
Families facing the growing demand for organ removal from their loved ones are questioning the possible suffering of the brainstem dead patient.A frequent question they ask to coordinating doctors is:Are you sure he w...Families facing the growing demand for organ removal from their loved ones are questioning the possible suffering of the brainstem dead patient.A frequent question they ask to coordinating doctors is:Are you sure he will not feel anything?Currently due to the risk of exacerbation of spinal reflexes and abnormal movements following surgical stimuli,it is recommended to use a curarization and an analgesic agent(most often morphine).The doses of opioids are less important than during usual anaesthesia,whereas the person is considered brainstem dead and there is no longer any cerebral integration of the pain.But what assures us that absolutely no more sensibility exists at this precise moment?Should the use of full analgesic dose of opioids not be continued anyway?Could this make the levies more"ethical"?展开更多
Objectives. To determine the feasibility and short and midterm results of laparoscopic pelvic exenteration for cervical cancer relapse. Materials and methods. Five patients with centra-pelvic recurrence within 3 to 13...Objectives. To determine the feasibility and short and midterm results of laparoscopic pelvic exenteration for cervical cancer relapse. Materials and methods. Five patients with centra-pelvic recurrence within 3 to 13 months after combined chemo-radiation therapy (associated to surgery for two cases) for cervical cancer tumors were included in a pilot study. Results. The procedures consisted in a complete pelvic exenteration with colo-anal anastomosis and ileal-loop conduit for 2 patients,a posterior pelvic exenteration including uterus,vagina and rectum with colo-anal anastomosis for 1 patient,an anterior pelvic exenteration including bladder and vagina with an ilealloop conduit for 1 patient and a anterior pelvic exenterationwith a laparoscopic hand assisted Miami Pouch for 1 patient. The 5 procedures were successful with no conversion to laparotomy. Time of procedure ranged between 4 h 30 and 9 hours. Average blood loss was 370 cc. Three patients developed metastatic recurrences and died. The two patients with anterior exenteration are alive and free of disease 11 and 15 months after the procedure. Conclusion. Laparoscopic pelvic exenteration procedures are feasible. A larger series is necessary to determine the advantages of this technique compared to laparotomy.展开更多
Massive obesity is an important risk factor in gynaecologic surgery. The traumatic effect of traditional laparotomy on the parietal wall is responsible for important perioperative morbidity. We describe the first repo...Massive obesity is an important risk factor in gynaecologic surgery. The traumatic effect of traditional laparotomy on the parietal wall is responsible for important perioperative morbidity. We describe the first reported case of an obese woman (Body Mass Index = 55 kg/m2) with stage IIA neuroendocrine carcinoma of the cervix treated by laparoscopy after radiochemotherapy. After a complete response to radiochemotherapy, the patient underwent laparoscopic hysterectomy and bilateral salpingo- oophorecto- my. The laparoscopic procedure was performed with a low- pressure pneumoperitoneum. She was discharged at day 2. No major complication was observed. Surgical and anesthesiological laparoscopic management in obese women are discussed.展开更多
Main text In the past decades,there have been several studies con-cerning the efficacy of sequencing of chemotherapy on disease control and survival in locoregionally advanced(LA)nasopharyngeal carcinoma(NPC).The addi...Main text In the past decades,there have been several studies con-cerning the efficacy of sequencing of chemotherapy on disease control and survival in locoregionally advanced(LA)nasopharyngeal carcinoma(NPC).The addition of concurrent cisplatin to radiotherapy has demonstrated survival improvements that are attributable to both dis-tant metastasis and locoregional control.Specific to the latter,the advent of intensity-modulated radiotherapy has resulted in superior tumor control given the bet-ter dosimetry compared to conventional techniques[1].However,distant recurrence still occurs in 20-30%patients and accounts for the main cause of death.To address this,several groups have explored the advantages of adding neoadjuvant chemotherapy(NACT)or adju-vant chemotherapy(ACT)to the backbone of concurrent chemoradiotherapy(CCRT).展开更多
文摘Introduction La modification du regard portésur l’objet«soin»affecte les pratiques de soin,dans une réflexion non plus uniquement centrée sur le remède,sur le soin en tant que«cure»,mais sur«la façon dont on donne le soin»[1]au sens oùWinnicott entend le《care-cure》[2];favorisant ainsi le développement de pratiques de soin innovantes,portée par une réflexion collective et pluridisciplinaire autour des patients.Si le soin en oncologie ne peut plus se penser ni se pratiquer en dehors d’une rencontre pluridisciplinaire autour du patient,il en va de même pour la recherche dans le domaine du cancer.
文摘The Sino-French 2012 Conference in Thoracic Oncology, held November 17-18, 2012, was hosted by the Department of Thoracic Surgery at Sun Yat-sen University Cancer Center and organized in collaboration with two prestigious French hospitals: Institute Gustave Roussy and Marie Lannelongue Hospital. The conference was established by leading experts from China and France to serve as an international academic platform for sharing novel findings in basic research and valuable clinical practice experiences. Hot topics including innovation in surgical techniques, diagnosis and staging of early-stage lung cancer, minimally invasive surgery, multidisciplinary treatment of lung cancer, and progress in radiotherapy for lung cancer were explored. Highlights of the conference presentations are summarized in this report.
文摘Families facing the growing demand for organ removal from their loved ones are questioning the possible suffering of the brainstem dead patient.A frequent question they ask to coordinating doctors is:Are you sure he will not feel anything?Currently due to the risk of exacerbation of spinal reflexes and abnormal movements following surgical stimuli,it is recommended to use a curarization and an analgesic agent(most often morphine).The doses of opioids are less important than during usual anaesthesia,whereas the person is considered brainstem dead and there is no longer any cerebral integration of the pain.But what assures us that absolutely no more sensibility exists at this precise moment?Should the use of full analgesic dose of opioids not be continued anyway?Could this make the levies more"ethical"?
文摘Objectives. To determine the feasibility and short and midterm results of laparoscopic pelvic exenteration for cervical cancer relapse. Materials and methods. Five patients with centra-pelvic recurrence within 3 to 13 months after combined chemo-radiation therapy (associated to surgery for two cases) for cervical cancer tumors were included in a pilot study. Results. The procedures consisted in a complete pelvic exenteration with colo-anal anastomosis and ileal-loop conduit for 2 patients,a posterior pelvic exenteration including uterus,vagina and rectum with colo-anal anastomosis for 1 patient,an anterior pelvic exenteration including bladder and vagina with an ilealloop conduit for 1 patient and a anterior pelvic exenterationwith a laparoscopic hand assisted Miami Pouch for 1 patient. The 5 procedures were successful with no conversion to laparotomy. Time of procedure ranged between 4 h 30 and 9 hours. Average blood loss was 370 cc. Three patients developed metastatic recurrences and died. The two patients with anterior exenteration are alive and free of disease 11 and 15 months after the procedure. Conclusion. Laparoscopic pelvic exenteration procedures are feasible. A larger series is necessary to determine the advantages of this technique compared to laparotomy.
文摘Massive obesity is an important risk factor in gynaecologic surgery. The traumatic effect of traditional laparotomy on the parietal wall is responsible for important perioperative morbidity. We describe the first reported case of an obese woman (Body Mass Index = 55 kg/m2) with stage IIA neuroendocrine carcinoma of the cervix treated by laparoscopy after radiochemotherapy. After a complete response to radiochemotherapy, the patient underwent laparoscopic hysterectomy and bilateral salpingo- oophorecto- my. The laparoscopic procedure was performed with a low- pressure pneumoperitoneum. She was discharged at day 2. No major complication was observed. Surgical and anesthesiological laparoscopic management in obese women are discussed.
基金MC reports personal fees from Astellas,personal fees from Janssen,grants and personal fees from Ferring,non-financial support from Astrazeneca,personal fees and non-financial support from Varian,grants from Sanofi Canada,grants from GenomeDx Biosciences,non-financial support from Medlever,outside the submitted workMC is supported by the National Medical Research Council Singapore Clinician-Scientist Award-#NMRC/CSA/0027/2018+2 种基金the Duke-NUS Oncology Academic Program Proton Research ProgramThis work was supported by grants from the National Key R&D Program of China(2017YFC0908500,2017YFC1309003)the National Natural Science Foundation of China(No.81425018,No.81672868,No.81602371).
文摘Main text In the past decades,there have been several studies con-cerning the efficacy of sequencing of chemotherapy on disease control and survival in locoregionally advanced(LA)nasopharyngeal carcinoma(NPC).The addition of concurrent cisplatin to radiotherapy has demonstrated survival improvements that are attributable to both dis-tant metastasis and locoregional control.Specific to the latter,the advent of intensity-modulated radiotherapy has resulted in superior tumor control given the bet-ter dosimetry compared to conventional techniques[1].However,distant recurrence still occurs in 20-30%patients and accounts for the main cause of death.To address this,several groups have explored the advantages of adding neoadjuvant chemotherapy(NACT)or adju-vant chemotherapy(ACT)to the backbone of concurrent chemoradiotherapy(CCRT).
