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OPTIMIZAREA DIAGNOSTICULUI I TRATAMENTULUI NEOPLAZIEI COLORECTALE

Autori:
(Conductor tiinific: Lucian Palii, confereniar universitar, Catedra Chirurgie nr.2 )
Introducere. Afeciunile tractului gastrointestinal se afl printre locurile de frunte n patologiile
neoplazice. Depistarea tardiv a acestora impune implementarea imperativ a unor metode eficiente si
contemporane de diagnosticare, precum i alegerea tacticii de tratament argumentate n scopul prevenirii
recidivelor.
Scopul lucrrii. Eficientizarea diagnosticului neoplaziei epiteliale colorectale cu selecia metodei optime
de tratament.
Materiale i metode. Studiu retrospectiv efectuat pe perioada anilor 2007-2015 pe un lot de 156 pacien i
cu vrsta cuprins ntre 15-84 ani. Pacienii au fost supu i urmtoarelor metode de investiga ie: RSS (85,0
%), irigoscopia (95,0 %), colonoscopia (84,3 %), FCS intraoperatorie (15,2 %).Tacticile de tratament
aplicate n funcie de diagnostic au fost: 1) metoda mini-invaziv i 2) interven ia chirurgical prin
laparotomie.
Rezultate. Pacieni diagnosticai cu polipi solitari i multipli au constituit 81,9 % din lotul total, cei cu
Polipoz Adenomatoas Familial 4,6 %, iar cei cu NECR malignizat 13,1 %. n urma stabilirii
diagnosticului, au existat 2 direcii de tratament: polipectomia endoscopic i transanal realizat la
81,9 % pacieni i intervenia chirurgical prin laparotomie n 17,7 % de cazuri.
Concluzii. Evoluia asimptomatic a etapelor iniiale ale NECR determin adresarea tardiv a pacien ilor
la serviciile medicale. Astfel, alegerea unor metode de diagnostic certe reprezint un element de baz n
screeningul maladiei. n adoptarea unei tactici de tratament al NECR este preferat polipectomia
endoscopic, pe cnd n cazul malignizrii polipilor se recurge la interven ia chirurgical prin laparotomie.
Cuvinte cheie: neoplazie colorectal, polipectomia endoscopic, interven ia chirurgical prin
laparotomie.
TREATMENT AND DIAGNOSIS OPTIMIZATION IN EPITHELIAL
COLORECTAL NEOPLASIA
Authors
(Scientific leader: Lucian Palii,____________ Chair of Surgery Nr 2)
Introduction. The affections of the gastrointestinal system take up one of the leading roles in the
neoplasical diseases. Their late interpretation imposes the imperative implementation of some efficient
and contemporary methods of diagnosis, as well as choosing an argumented approach of treatment to
prevent relapses.
Objective of the study. The efficiantization of the diagnosis of epithelial colorectal neoplasia with the
selectionof an optimal treatment method.
Material and methods. Retrospective study made in the period of 2007-2015 on a lot of 156 patients
ranking between 15-84 years. The patients were submissed to the following methods of investigation:
rectoromanoscopy (85,0 %), irigoscopy (95,0 %), colonoscopy (84,3 %), intraoperatory fibrocolonoscopy
(15,2 %). The treatment technique was chosen acoording to the diagnosis: 1) the mini-invasive methods
and 2) the surgical intervention through laparotomy.
Results. Patients diagnosed with single or multiple adenomatous polyps constituted 81,9 % of the whole
lot, those with familial adenoumatous polyposis 4,6 % and those with malignant polyps 13,1 %. After
establishing the diagnosis, there were 2 directions of treatment: endoscopic and transanal polypectomy
done in 81,9 % of cases and surgical intervention through laparotomy in 17,7 %.
Conclusions. The asymptomatic evolution of the initial stage of ECRN determines the late addressability
of patients to the medical healthcare service. Therefore, choosing a specific diagnostic path is an essential
element of screening of the disease. When selecting a treatment procedure of the ECRN it is preferably to
use endoscopic polypectomy, whereas in the case of malignant polyps surgical intervention through
laparotomy is more applicable.
Keywords: colorectal neoplasy, endoscopic polypectomy, surgical intervention through laparotomy.