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Master Thesis

Rôles et limites de la chirurgie dans la prise en charge des nodules et micro-nodules pulmonaires chez les enfants porteurs de tumeur solide : revue d’expérience du CHU de Grenoble

Abstract : INTRODUCTION: Indications for surgical management of pulmonary nodules in children with cancer vary greatly according to the histological type of the primary tumor. The main objective of the study was, through our experience, to evaluate the benefits of surgical excision of these nodules whether it was a diagnostic or curative indication. METHODS: We performed a monocentric retrospective descriptive study of 22 patients operated between January 1998 and 2018. Surgery was considered effective if it allowed to obtain a diagnosis of certainty and to guide oncological management or treatment, or to perform a complete excision of the metastases. RESULTS: 27 surgeries were performed, 11 for diagnostic purposes, 16 for curative purposes. A benefit was provided by 81.8% of diagnostic surgeries and 62.5% of curative surgeries. The quality of surgical excision seems to be a major prognostic factor, except for patients presenting only micro-nodules at diagnosis. The failure to locate deep micro-nodules affects 33.3% of the interventions in our series. DISCUSSION: Indications for surgical excision of these nodules are varied and protocol recommendations specific to each tumor oversees them. Our study emphasizes the importance of excisional quality on overall survival and survival without recurrence. The main limitation seems to be the intraoperatively spotting of deep nodules. Radio-guided localization techniques could improve its efficiency and promote the use of thoracoscopy, currently recommended only for diagnostic surgeries.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01891131
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Submitted on : Tuesday, October 9, 2018 - 11:55:37 AM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
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Romain Faguet. Rôles et limites de la chirurgie dans la prise en charge des nodules et micro-nodules pulmonaires chez les enfants porteurs de tumeur solide : revue d’expérience du CHU de Grenoble. Médecine humaine et pathologie. 2018. ⟨dumas-01891131⟩

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