Lazarchuk V. Endoscopic diagnosis and minimally invasive endo surgical interventions in colon neoplasias

Dissertation is being devoted to the study of peculiarities of the objectification of endoscopic diagnosis and treatment of patients with colon neoplasias, and development of new methods and techniques for endoscopic diagnosis and minimally invasive endoscopic surgical interventions. Dissertation presents results of the effective application of the twofold take of polyethylene glycol from 480 mg of simethicone, and a single take of macrogol 3350 (in a day of colonoscopy procedure) from 360 mg of the simethicone, and individual approach to the preparation for and the colonoscopy procedure itself in the optimal time period after the termination of preparation. Consequently, there was observed аn A level of large intestine clearance for 60,5 % and 63,1 % of patients, and B level of clearance for 39,5 % and 36,9 % of patients respectively. Improvement of the colon pan-chromoscopy with 0.2 % solute of Indigo Carmine went along with examination lengthen by 8.54 ± 3.6 min. However, simultaneous identification of colon neoplasias up to 10 mm has improved by 19.3 %. Also, execution of biopsy with forceps in order to identify morphological nature of colon neoplasias is not justified because of its low sensitivity - 70.3 %. Predictions of the morphologic diagnosis during examination under the white light with zoom in and chromoscopy (optical diagnosis) has been featured with sensitivity of 89 % for adenomatous and 87.6 % for hyperplastic lesions, while the study of biopsy material 73 % and 68.3 %, respectively. Application of the developed algorithm of diagnostics and treatment of patients with neoplasia of the colon has reflected in the increased number of detected and removed neoplasias by 3.7 times, and reduced duration of the colonoscopy by 5 ± 3.2 min; number of repeated colonoscopies decreased by 16 %.