GASTRO-INTESTINAL

The treatment of diseases –  particularly cancers -  which affect the gastro-intestinal tract (organs from mouth to anus, along the alimentary canal) are considered to be of French medicine excellence.

Beyond the development of innovative medicine and surgical equipment along with less invasive endoscopic techniques, current evolutions include 3D imagery, robotics and transplants.

Outstanding surgery is regularly performed, such as the transplant into a child of a complete block of 7 organs - from the stomach to the colon, via the kidneys – performed by a team in 2011, led by Pr. Chardot from Necker – Enfants Malades Hospital in Paris. 

Today, there are 891 French hospitals and clinics dealing with abdomen hernia surgery, 818 with gallbladder, 814 with appendicectomy, 741 with colon and intestine, 480 with obesity, 455 with proctology, 375 with rectum, 323 with esophagus and stomach, 247 with liver and pancreas.

Among these, C3Medical is proud to work closely with Necker – Enfants Malades for children and young adults and with Institut Mutualiste Montsouris / IMM in Paris for adults, managing its international patient activity (for more information, please see video in the main section "Care for Complex Pathologies" and description in "C3Medical Hospital Network" by clicking on the logo in the banner below).

DIGESTIVE CANCERS

What are digestive cancers?

With over 42,000 new cases diagnosed each year in France, colon and rectal cancers are by far the most common primary cancers of the digestive tract. This frequency justifies the introduction a few years ago of systematic screening for people aged 50 to 74 (as with breast cancer screening for women). If there are no particular risk factors, this screening involves a test every two years to search for a microscopic hemorrhage in the stool, which, if positive, is followed by a colonoscopy.

Pancreatic cancer has become much more common in recent decades. It is now the second most-common digestive cancer, ahead of stomach and esophageal cancer. Primary cancers of the small intestine are exceptional.

Primary cancers of the liver are rare and generally exacerbate the development of an underlying liver disease. Patients with cirrhosis, for which there are many causes, are the most at risk. In the liver, there can also be tumors known as liver metastases, since they come from another cancer that has spread to the liver. These are more frequent than primary cancers of the liver. They can be isolated or part of a spread to other organs (such as the lung) and/or the peritoneum (known as peritoneal carcinomatosis).

The symptoms that reveal digestive cancers depend on the organ affected.

A small number of these cancers occur due to genetic predisposition. These are known as hereditary forms of cancer. Hereditary forms of colon and rectal cancer are the most frequent. There are different types, the most common being Lynch syndrome (also known as HNPCC syndrome) and familial adenomatous polyposis. There are also hereditary forms of pancreatic and stomach cancer. In all cases, it is vital to identify individuals that have these genetic predispositions, given the impact for their own treatment (screening and sometimes specific therapy) and for that of their relatives.

Source: https://institut-curie.org/liste/different-types-cancer

7 ORGANS TRANSPLANTED INTO A CHILD

In 2010, at the Necker-Enfants Malades Hospital of Paris, in the greatest discretion, a child received a transplant of seven organs, from the stomach to the colon, via the kidneys.  

Explanations with Pr. Christophe Chardot, Head of Pediatric and Transplant Surgery at Necker Hospital, one of the three surgeons who performed this multi-organ transplant 

It's an amazing operation, the last chance operation. In 2010, Erika, a German girl aged 5 at the time, receives the liver, the two kidneys, the stomach, the small intestine, the right colon and finally the duodeno-pancreas of the same donor. 

Since her birth, Erika has been living with Hirschsprung's disease, one of the most common malformations of the digestive tract, a condition that prevents the terminal part of the bowel from working well. In his case, it is the whole area of the stomach to the rectum that does not work. The nerves of the digestive wall being malformed, the digestive tract cannot contract normally to ensure the progression of food. Result: intestinal transit is not done, the girl cannot eat normally and all other organs are affected. The only solution is the transplant.

Twelve hours of surgical intervention

At the Necker Hospital, three surgeons are preparing for this multi-organ transplant in the operating room. 

Pr. Sabine Irtan, Pr. Yves Aigrain and Pr. Christophe Chardot will work for twelve hours. "We removed all the diseased organs in one bloc that we replaced with the graft in one bloc," says Professor Christophe Chardot. "The impression is strange because the abdomen is completely unoccupied, it is a situation that we do not meet very often in surgery". 

After the intervention, the girl is supported by a resuscitation team. It will take several weeks of complex care, involving hepatology, immunology radiology so she can go home. 

This transplant of several organs was not a world first, but it is the culmination of the intestinal transplant that began a few years ago by the intestine alone then by the intestine and the liver until arriving in the case of Erika, to all the digestive organs. The other difficulty was to find a graft of suitable size for the child, it can take several months or even years.

An almost normal life

Today, the little girl aged 8 and a half is fine. She has found an almost normal life, she goes to school, and no longer has a catheter. Thanks to her new intestine, she is cured of Hirschprung's disease.

Erika eats almost normally, at night only she receives a supplement of food thanks to a gastrostomy, a small button which goes directly in the stomach. Nevertheless, explains Prof. Chardot, "this little girl will have anti-rejection treatment for life, but also a very close monitoring to check that her organs do not show rejection and that she does not develop complications of immuno-suppressive treatment especially infections or tumors ".
 

Source : “Allodocteurs.fr” – 08 April 2014

DIGESTIVE CANCERS

What are digestive cancers?

With over 42,000 new cases diagnosed each year in France, colon and rectal cancers are by far the most common primary cancers of the digestive tract. This frequency justifies the introduction a few years ago of systematic screening for people aged 50 to 74 (as with breast cancer screening for women). If there are no particular risk factors, this screening involves a test every two years to search for a microscopic hemorrhage in the stool, which, if positive, is followed by a colonoscopy.

Pancreatic cancer has become much more common in recent decades. It is now the second most-common digestive cancer, ahead of stomach and esophageal cancer. Primary cancers of the small intestine are exceptional.

Primary cancers of the liver are rare and generally exacerbate the development of an underlying liver disease. Patients with cirrhosis, for which there are many causes, are the most at risk. In the liver, there can also be tumors known as liver metastases, since they come from another cancer that has spread to the liver. These are more frequent than primary cancers of the liver. They can be isolated or part of a spread to other organs (such as the lung) and/or the peritoneum (known as peritoneal carcinomatosis).

The symptoms that reveal digestive cancers depend on the organ affected.

A small number of these cancers occur due to genetic predisposition. These are known as hereditary forms of cancer. Hereditary forms of colon and rectal cancer are the most frequent. There are different types, the most common being Lynch syndrome (also known as HNPCC syndrome) and familial adenomatous polyposis. There are also hereditary forms of pancreatic and stomach cancer. In all cases, it is vital to identify individuals that have these genetic predispositions, given the impact for their own treatment (screening and sometimes specific therapy) and for that of their relatives.

Source: https://institut-curie.org/liste/different-types-cancer

7 ORGANS TRANSPLANTED INTO A CHILD

In 2010, at the Necker-Enfants Malades Hospital of Paris, in the greatest discretion, a child received a transplant of seven organs, from the stomach to the colon, via the kidneys.  

Explanations with Pr. Christophe Chardot, Head of Pediatric and Transplant Surgery at Necker Hospital, one of the three surgeons who performed this multi-organ transplant 

It's an amazing operation, the last chance operation. In 2010, Erika, a German girl aged 5 at the time, receives the liver, the two kidneys, the stomach, the small intestine, the right colon and finally the duodeno-pancreas of the same donor. 

Since her birth, Erika has been living with Hirschsprung's disease, one of the most common malformations of the digestive tract, a condition that prevents the terminal part of the bowel from working well. In his case, it is the whole area of the stomach to the rectum that does not work. The nerves of the digestive wall being malformed, the digestive tract cannot contract normally to ensure the progression of food. Result: intestinal transit is not done, the girl cannot eat normally and all other organs are affected. The only solution is the transplant.

Twelve hours of surgical intervention

At the Necker Hospital, three surgeons are preparing for this multi-organ transplant in the operating room. 

Pr. Sabine Irtan, Pr. Yves Aigrain and Pr. Christophe Chardot will work for twelve hours. "We removed all the diseased organs in one bloc that we replaced with the graft in one bloc," says Professor Christophe Chardot. "The impression is strange because the abdomen is completely unoccupied, it is a situation that we do not meet very often in surgery". 

After the intervention, the girl is supported by a resuscitation team. It will take several weeks of complex care, involving hepatology, immunology radiology so she can go home. 

This transplant of several organs was not a world first, but it is the culmination of the intestinal transplant that began a few years ago by the intestine alone then by the intestine and the liver until arriving in the case of Erika, to all the digestive organs. The other difficulty was to find a graft of suitable size for the child, it can take several months or even years.

An almost normal life

Today, the little girl aged 8 and a half is fine. She has found an almost normal life, she goes to school, and no longer has a catheter. Thanks to her new intestine, she is cured of Hirschprung's disease.

Erika eats almost normally, at night only she receives a supplement of food thanks to a gastrostomy, a small button which goes directly in the stomach. Nevertheless, explains Prof. Chardot, "this little girl will have anti-rejection treatment for life, but also a very close monitoring to check that her organs do not show rejection and that she does not develop complications of immuno-suppressive treatment especially infections or tumors ".
 

Source : “Allodocteurs.fr” – 08 April 2014