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Diagnostico-curative attitude in the treatment of volume formations of adrenal glands"


Author: Bujac Mariana
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2009
Scientific adviser: Vladimir Hotineanu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 23 October, 2009
Approved by NCAA on the 17 December, 2009

Abstract

Adobe PDF document – 0.48 Mb / in romanian

Keywords

volume formation of adrenal gland, aldosteroma, androsteroma, corticosteroma feocromocitoma, adrenalectomy

Summary

The thesis is displayed on 133 pages and contains Introduction, 6 chapters, bibliography of 192 titles, 30 figures and 34 tables. The results were published in 5 scientific articles. Field of the study. In the thesis were reported the results of surgical treatment of 81 patients with VFAG and curative management of each form of pathology separately, treated in Clinic of Surgery 2 of State Medical University ”N. Testemitanu", during the period of 1996-2008 years, 19(23,46%) of them were with aldosteromas, 11(13,58%) patients with corticosteromas, 9(11,11%) with feochromocytomas, 10(12,35%) with androsteromas and 32(39,51%) patients with hormonal non-active tumors.

The aim of the study. The study of clinical and paraclinical particularities of patients with volume formations of adrenal glands and to propose a contemporary surgical treatment. The objectives of the study was examining the evolution and clinical particularities of adrenal tumors depending on the hormonal activity and morphological shape, their assessment of the comparative value of diagnostic tests, hormonal, imaging in the positive diagnosis of adrenal tumors, the establishment of optimal surgical techniques in adrenalectomyes and efficacy treatment of operated patients.

The novelty and scientific originality. In the study has argued, that the screening tests for differential diagnosis of adrenal tumors are hormonal and imaging examinations (TC, MRI), was eleborated algorithms of differential diagnosis for each nosological forms, was argued elective methods of surgical treatment ( enucleation, resection, adrenalectomy) depending on the clinicomorfological shape of adrenal tumors, was established criteria for assessing the quality of life depending on their functional status.

Theoretical signification. Understanding the evolutionary particularities of patiens with FVAG offers the possibility to prevent the blood injuries and adrenal insufficiency during and after the adrenalaectomy.

Scientific value and clinlcal applicability. The algorithm of diagnosis and treatment of the volume adrenal formation proposed, allowed selection of different methods of diagnosis, preoperatory training and surgical treatment of patients. Surgical treatment provided a good quality of life of the majority patients investigated in the study and led them to a early sociofamilial and training rehabilitation.

Implimentation of scientific data.The diagnostic and treatment algorithms proposed, specified schemes preoperator, the surgical treatment and postoperator treatment were applied to all patients with adrenal volume formations, treated in the clinic of Surgery 2 and Clinic of Endocrinology in the CRH.