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The diagnostic and surgery management of malignant colorectal occlusion


Author: Aureliu Gonţa
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2008
Scientific adviser: Vladimir Hotineanu
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 12 March, 2008
Approved by NCAA on the 19 June, 2008

Abstract

Adobe PDF document0.39 Mb / in romanian

Thesis

CZU 616.345-007.272-006-07-089

Adobe PDF document 2.29 Mb / in romanian
140 pages


Keywords

colorectal cancer, colorectal tumoural occlusion, diagnostic and surgical management, quality of life patients

Summary

The urgency of the colorectal cancer (CRC) problem is not only a steady increase in the incidence of this pathology in the last decade, but in the unsatisfactory results of surgical treatment. CFR (postoperative lethality reached) of these patients, according to the literature, is 22-73%.

The clinic surgery Nr.2 MKGU and F "N. Testemitanu" in the 1994-2006 period, 524 patients were hospitalized with CRC. The thesis presents the results of the integrated treatment of 182 patients who had used a new treatment and diagnostic algorithm in order to improve the quality of life of patients.

Algorithm diagnosis of this disease include subjective, objective clinical symptoms, a number of clinical and biochemical parameters, USG of the organs of the ultrasounography, roentgenoscopy, ergography, RRS, colonoscopy, computer tomography and nuclear magnetic resonance.

Surgical treatment, in most cases, - 170 (93,4%) were radical, only 12 (6,6%) cases were made palliative operation.

Histology structure in almost all cases characterized as adenocarcinoma of varying degrees of differentiation. Morfopatological signs of the CRC stage are identified as compensated, subcompensated and decompensated.

Postoperative complications detected at the 42 (23%) patients. In the postoperative period, died 11 (6,0%) patients. All cases of deaths were among elderly people with decompensated form of enteric CRC.

There was obtained a survival from during 5 years at the radically operated patients – 59,7%. Using standardized quality of life parameters, we found favorable results with 72,8% of patients by 5 years postoperative period, 54,2% rehabilitated professionally.

The algorithms for diagnosis and treatment, that we have developed considerably facilitate the adoption of appropriate solutions to difficult situations arising from the peculiarities of this pathology.