Attestation committee
Accreditation committee
Expert committee
Dispositions, instructions
Normative acts
Nomenclature
Institutions
Scientific councils
Seminars
Theses
Scientific advisers
Scientists
Doctoral students
Postdoctoral students
CNAA logo

 română | русский | english

CNAA / Theses / 2005 / June /

Colon and Rectum Epithelial Neoplasia Diagnosis and Treatment Aspects


Author: Lucian Palii
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2005
Scientific adviser: Vladimir Hotineanu
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Nicolae Barbacar
doctor habilitat, professor, Institute of Genetics, Physiology and Plant Protection, Academy of Sciences of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 24 June, 2005
Approved by NCAA on the 22 September, 2005

Abstract

Adobe PDF document0.45 Mb / in romanian

Summary

The goal of this research was to improve the diagnosis and treatment strategy of solitary, and multiple sporadic, hereditary colon and rectum polypus, as well as familial adenomatous polyposis (FAP). The work was carried out by the Surgery Department No. 2, Clinic No. 1 of the Medical and Pharmaceutical State University named after “Nicolae Testemitsanu” within the Republican Clinical Hospital and Molecular Genome Organization and Gene Expression Laboratory of the Genetics Institute of the Republic of Moldova Academy of Science.

The research was based on the analysis of the clinical material of surgical treatment of 154 patients diagnosed with colon and rectum epithelial neoplasia (CREN) (including the suspected patients) carried out during 1993-2004 period, including patients with solitary or multiple sporadic or hereditary adenomatous polypus, familial adenomatous polyposis whose age varied from 8 to 78 years. Out of the total number, the retrospective patients constituted 112 cases and the prospective ones – 42 cases.

The research also included estimates of some epidemiological CREN indices for the country, as well as diathesis factors contributing to the appearance of neoplasia studied on the territory of the Republic of Moldova. Having used the RT-PCR technique, the genetic study helped us diagnose, for the first time in the Republic Moldova, the hereditary origin of colon and rectum polypus on molecular level. Here in, we refer, in particular, to the Lynch Syndrome, as well as the family adenomatous polyposis.

In our study we have analyzed the surgical and therapeutical activity of the clinic encompassing 139 patients with CREN, out of which 95 patients with solitary polypus of sporadic and hereditary origin, 33 patients with multiple polypus of sporadic and hereditary origin and 11 patients with familial adenomatous polyposis. Having analyzed the early and tardive results of the treatment carried out for CREN patients, we can conclude that once identified colon and rectum adenomas should be removed and, preferably, endoscopically provided that patients do not have contraindications for it.

With reference to the results of Familial Adenomatous Polyposis surgical management, one certain conclusion can be drawn, based on our experience, that surgery is considered the only reasonable method of FAP treatment. The importance of preserving a portion of the colon contributes to the post-operative life quality of the patients with FAP, which has actually been the strategic primary goal pursued by the specialists of our clinic.

Besides, a special algorithm for colon and rectum epithelial neoplasia diagnosis was developed with practical application of modern genetic diagnosis through the use of RT-PCR technique that allows substantially improving the CREN diagnosis and pre- and post-operative treatment strategy.