Anexa 15

GHID DE DIAGNOSTIC, TRATAMENT I URMRIRE PENTRU TUMORILE

RETROPERITONEALE PRIMITIVE
Protocol de diagnostic obligatoriu:
1. Anamnez + Examen clinic
2. Protocolul minim investigational al pacientului chirurgical urologic
. Ecogra!ia abdominal
". #adiogra!ie pulmonar
5. $omogra!ia computerizat abdomino%pelvin cu contrast sau &#'
(. Examen histopatologic )punc*ie+ biopsie chirurgical+ piesa de exerez,
Protocol de diagnostic op*ional:
1. $-+ &#' pulmonar
2. .cintigram osoas
. /rogra!ie
". Evaluare hematologic % lim!oame
5. Endoscopie digestiv0irigogra!ie
(. Eco%1oppler cavo%cardiac
2. 3iopsie eco%tomoghidat
4. Arteriogra!ie
5. 'ar6eri tumorali
17. Pro!il endocrin % .#+ pancreas
11. -onsulturi interclinice !unc*ie de patologia asociat
Protocol de tratament:
-hirurgical:
1. $umorectomie radical )lombar0transperitoneal,
2. $umorectomie + interven*ii asociate !unc*ie de extensia tumorii+ cu viz de radicalitate
. 3iopsie chirurgical
-hirurgical op*ional:
1. $umorectomie paliativ % durere+ hemoragie+ compresie 8 interven*ii asociate implicite
2. -hirurgia metastazelor extirpabile 8 viz radical
. -hirurgia paliatic a complica*iilor
9p*ional:
1. -himioterapie
2. #adioterapie
. &munoterapie
-ontrol % la ( luni :n primii doi ani apoi anual
% $- )&#', abdominal 8 toracic+ examen clinic+ mar6eri tumorali
1