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Value estimation and comparison of diagnostic methods for primary retroperitoneal tumours


Author: Șchiopu Victor
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2023
Scientific advisers: Nicolae Ghidirim
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Vasile Ţurcan
doctor, associate professor (docent)
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 5 October, 2022
Approved by NCAA on the 24 February, 2023

Abstract

Adobe PDF document – 1.49 Mb / in romanian
Adobe PDF document – 1.52 Mb / in english

Thesis

CZU 616.381-006-07(043.2)

Adobe PDF document 3.09 Mb / in romanian
103 pages

Keywords

Primitive retroperitoneal tumors (PRT), retroperitoneal space, diagnosis

Summary

Study objectives:
1. Estimation of the degree of informativity and accuracy of imaging methods in the diagnosis of primitive retroperitoneal tumors.
2. Determining the role of laparotomy, laparoscopy and morphopathological examination in the diagnosis of primitive retroperitoneal tumors.
3. Comparative analysis of diagnostic-therapeutic results obtained in the study group.
4. Development of an early diagnostic algorithm of PRT and its implementation in the activity of surgeons and oncologists practitioners

Solved scientific problem:
1. It was determined the primacy of computerized tomography with intravenous contrast in the diagnosis of PRT.
2. The role of laparotomy in the diagnosis of PRT was established due to the visualization of the tumor with its macroscopic carcateristics and the microscopic and immunohistochemical examination of the extirpated tumor or of the bioptic material, establishing the morphological picture.
3. Estimating the comparative value of the obtained results, the main role of immunohistochemical examination has been demonstrated, especially in the diagnosis of some forms of sarcoma and determining their degree of differentiation, which allows to establish the treatment tactics.
4. Based on the results obtained, it was possible to develop a behavioral algorithm in the diagnosis of PRT.

Novelty and originality of the study:
The scientific novelty and originality lies in the fact that PRT diagnosis requires a thorough clinical- imagistic and surgical effort (diagnostic laparotomy) in the early establishment of these pathologies. A diagnostic algorithm was developed through comparative evaluation of diagnostic methods. Each method has been demonstrated to have a reliable diagnosis of PTR with the finding of tumor origin in the histological and immunohistochemical examination result. Based on this algorithm, a conduct of investigations in helping clinicians was recommended, first of all surgeons and oncologists who will receive information and logistical support to guide step by step in the application of diagnostic methods of PRT.

Theoretical significance: It consists in conducting a comparative study of the results obtained from the use of complex diagnostic methods to streamline the diagnostic act in the PRT.

Applicative value of research: The results obtained required the establishment of an effective diagnostic algorithm. Based on this algorithm a methodological conduct of early diagnosis of PRT for surgeons and oncologists was recommended.

Implementation of scientific results The results of the study were implemented in the daily practice of the Department of Gastrology, Proctology, Urology and ALM Tumors as well as in the respective offices of the Diagnostic Advisory Center (DAC) of the IMSP IO.

Publications on the thesis topic: On the topic of the study were published 12 publications, of which 2 articles in international journals, 3 in national journals (category B), 9 abstracts in international and national congresses and conferences with international participation, 4 certificates of innovator

Summary of the thesis compartments: The thesis includes: introduction, 3 chapters, the synthesis of the obtained results, general conclusions, practical recommendations; the bibliographic index, the annexes, the list of abbreviations, are attached.

Summary of results obtained. The relevant results of the research shall be interpreted in relation to the objectives and assumptions undertaken, with the results of other researchers of the field investigated.