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    Comparative retrospective study for surgically treated primary VUR in pediatric patients
    (2023-03)
    ;
    Radmila Mila Mihajlova Ilie
    ;
    Magdalena Gjorik Petrushevska
    ;
    Gani Çeku
    ;
    Introduction Vesicoureteral reflux have incidence of about 1% in pediatric population. It is a very common pediatric condition. Anomalies of the ureter, the dynamics of the bladder, and the anatomy of the ureterovesical junction can lead to abnormal valve mechanisms and vesicoureteral reflux. Aim The purpose of this study is to evaluate the effectiveness of open and endoscopic urethral reimplantation in relation to the severity of the vesicoureteral reflux and renal function. Materials and Methods We retrospectively analyzed 53 children treated for primary vesicoureteral reflux at the Clinic of Pediatric Surgery in Skopje in the period from 2017 to 2020. Endoscopic treatment was done using subureteric Teflon injection “STING” technique. Operative treatment (open procedure) was used in higher grade vesicoureteral reflux (3 or 4). The evaluation of the results of the treatment was done mainly according to the following criteria: reduced grade of reflux, maintaining renal function, absence of urinary infection and postoperative complications. These outcomes were compared between the two techniques. Results and Discussion The endoscopic procedure was shown to be superior for lower grade vesicoureteral reflux. The open procedure is preferable in cases of higher vesicoureteral reflux or after failure with the endoscopic procedure. Conclusion Treatment of vesicoureteral reflux with the endoscopic procedure is always preferable due to fewer days of hospitalization and as a minimally invasive approach. Both procedures proved to be effective in reflux correction, and successfully reduce the occurrence of febrile urinary tract infections.
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    PNEUMOTHORAX TREATMENT IN PATIENTS WITH EMPHYSEMATOUS LUNGi DISEASE WITH TWO DIFFERENT TECHNIQUES.
    ("Ss Cyril and Methodius"University, Faculty of Medicine, Skopje, R. N. Macedonia, Department of Anesthesia and Reanimation, 2017)
    Jakupi N
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    ;
    Dzikovski I
    ;
    ;
    Maric N
    Objective: to compare the outcomes of thoracotomy and video-assisted thoracoscopic sur- gery (VATS) in the treatment of pneumothorax in patients with emphysematous lung disease. Заклучок: Според освртот врз литературата јасно е дека ларингоскопијата и интубацијата може да предизвикаат хемодинамиска нестабилност со појава на неспецифични варијации во ST-T сегментот. Тоа е несакан сучај на кој секогаш треба да се мисли, особено кај хипертензивните пациенти кои се третирани со RAS антагонистите, кои предизвикуваат значаен пад на артерискиот крвен притисок, кој е пак одговорен за коронарната вазоконстрикција и промените во големината на ST сегментот. Главните промени се случуваат 5 минути по интубацијата. Method and Material: in prospective study we analyzed the level of postoperative compli- cations, duration of drain presence, total drain collection, site infections, length of hospital stay (LOHS) and recurrence of pneumothorax in two groups of patients. Group OT (n=12) included patients undergoing open thoracotomy and group VATS (n=12) underwent VATS for primary pneumothorax treatment. | 26 | Number 3. December 2017 | 27 | ABsTrACT results: Demographic data between the groups was homogenous. Duration of drain presence was 4.08 vs. 3.8 days in respect to the groups. Statistically significant large amount of drain collection was found in the OT group (604.1 ml vs. 391 ml). Length of hospital stay was statis- tically longer in group OT (p=0.02). Two patients had recurrent pneumothorax in VATS group. Conclusion: According to our study patients, who undergo VATS, postoperatively have lower amount of drain collections, have drain presence for less days, have less days spent in the hospital, but have increased recurrence rate. Even though our study has small number of patients included, it opens a door to larger study to confirm the results.
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    A RARE CASE OF MENINGEAL HEMANGIOPERICYTOMA ACCOMPANIED WITH INTRAOPERATIVE BLOOD LOSS
    (Department of Anaesthesia and Reanimation, Medical Faculty "Ss Cyril and Methodius", Skopje, R. Macedonia, 2020-12)
    ;
    Gligorievski A
    ;
    Nevcev I
    Introduction: Meningeal hemangiopericytomas are rare tumors of the meninges which are aggressive and pathohistologically belong to solitary fibrous tumors of the dura. The tumor might be found throughout the entire CNS, usually superficially and closely related to the meninges. Important characteristic is that they have a strong tendency for local recurrence and also are associated with extra cranial metastasis. Case Report: In this study, we present a case of 71 years old man primarily asymptomatic, who presented with sudden symptoms of headache, dizziness, and loss of consciousness. He was immediately transferred to the department of urgent medicine where primary computer tomography (CT) scan was done. For a certain diagnosis to be established magnetic resonance imaging (MRI) was secondly done. MRI showed extra axial, solitary, supratentorial masses, lobulated in contour, highly vascular with a tendency to erode the nearby parietal bone. In T1 and T2 waited images it was isointense to grey matter. In Diffusion waited images (DWI) this tumor showed intermediate restricted diffusion (less than meningioma). After intravenous application of contrast medium – gadolinium, it shows vivid enhancement, heterogeneous, and a dural tail sign was seen. Total surgical excision was done with the complication of intraoperative bleeding, and the diagnosis of meningeal hemangiopericytoma obtained on MRI was pathohistological confirmed. Conclusion: Meningeal hemangiopericytoma (HPC) are aggressive lesions with a tendency for extracranial metastasis, also this tumor has a tendency for high rates of recurrence, and is characterized with local aggressive behavior. On both CT and MRI modality distinguishing a hemangiopericytoma from a meningioma, sometimes can be difficult because of their similar appearance, but is important the interpretation to be adequate especially with MRI because of the need for pre-operative catheter embolization in order to prevent the intraoperative blood loss, and also adjuvant radiotherapy might be required to reduce the risk of local recurrence and distant metastasis