Faculty of Medicine

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Author: search.filters.author.Markov, PetarHas files: Yes

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    ЛАПАРОСКОПСКА ТАПП НАСПРОТИ ПОПРАВКА ПО LICHTENSTEIN; РАН КЛИНИЧКИ ИСХОД
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2020)
    Mitevski, Aleksandar
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    Markov, Petar
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    Introduction. Laparoscopy as a minimally invasive technique has itsplace in inguinal hernia repair. Lower postoperative pain, earlier mobilization and earlier return to usual activities are comparable to an initially high cost of the hospital charge. Also, there is a lower percentage of postoperative complications especially related to the wound. Methods. The study was designed as a prospective randomized controlled study conductedin a three-year-period. Sixty-five patients were randomly assigned into two groups, examined-35 patients treated with TAPP technique and controlled-30 patients treated with Lichtenstein technique. Surgicaltime, preoperative pain, hospital stay, postoperative analgesia, functional status and convalescence were evaluated. The postoperative complications, hematoma, seroma, wound infection and urinary retention were also taken into consideration. Results. A significant diference was found in the surgicaltime favoring Lichtenstein over TAPP technique; postoperative hospitalization was significanlly longer in case of the Lichtenstein procedure. There wasa significant difference concerning postoperative pain and functional status between the groups, as well as in the same group regarding the postoperative days. The percentage of early postoperative complications wassignificantly lower in TAPP group (6.3% versus 16.7%); there wasa significant difference in convalescence (TAPP 4.6±1.2 / Lichtenstein 6.6±1.10). Conclusion. Patients treated with laparoscopic TAPP technique had better early clinical outcome compared to open Lichtenstein technique. It is a result of a lower intensity of the postoperative pain, less postoperative complications which leads to a shorter hospital stay, better functional status and short convalescence.
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    Cecum Volvulus, In Misdiagnosis of Acute Appendicitis: a case report
    (2021-11-30)
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    Jovanovska, Frosina
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    Mustafova, Alma
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    Dervisov, Kristijan
    Cecum Volvulus, In Misdiagnosis of Acute Appendicitis: a case report Şenol Tahir, Martina Ambardjieva, Frosina Jovanovska, Alma Mustafova, Kristijan Dervisov, Nimetula Limani, Petar Markov, Berat Dalipi University Clinic for Surgical Diseases, General and Abdominal Departemen – St.Naum Ohridski, Skopje, N. Macedonia Background: As a type of intestinal malrotation, colon volvulus is most common in the sigmoid, followed by the caecum and then the transverse and splenic flexure. The cause of volvulus may be due to embryologically incomplete rotation of the intestine, Ledd’s bands, long mesocolon, or dolichocolon. Methods/Results: Preoperative diagnosis of cecal volvulus is usually accidental and can be confirmed by CT of the abdomen, and it is an incidental intraoperative finding in most cases. We present a patient with an operative diagnosis for acute appendicitis, with Alvarado score of 8 and positive ultrasonographic signs for acute appendicitis. On laparoscopic exploration for appendectomy, an enormously dilated colon (bigger cystic formation) affects the entire pelvis. The conversion was performed with lower median laparotomy, cecal volvulus found with 360-degree rotation in the direction of the clock’s hands with more significant deterioration of the caecum. Right hemicolectomy was performed with ileum- transverse colon double GIA stapler anastomosis. On the 6th postoperative day, the patient was discharged home. Conclusions: Cecal volvulus although a rare acute surgical condition should be recognized and properly surgically treated.
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    Giant Retroperitoneal Liposarcomas with Involving Adjacent Abdominal Organs: Two case reports
    (2022-09-15)
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    Jovanovska, Frosina
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    Mustafova, Alma
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    Bundovska, Marija
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    Panic, K
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    CORRELATION OF SCORING SYSTEMS WITH HISTOPATHOLOGICAL FINDINGS AND THEIR IMPORTANCE IN REDUCING THE PERCENTAGE OF UNNECESSARY APPENDECTOMIES
    (Македонско лекарско друштво = Macedonian medical association, 2019)
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    Markov, Petar
    Introduction. Acute appendicitis (AA) is one of the most common emergency surgical conditions, where emergency laparotomy is necessary. However, perforation rates and negative laparotomies during this procedure have not been reduced. The purpose of this paper was to evaluate the importance of the scoring systems in the differenttial diagnosis for setting an indication for appendectomy. Method. Prospective comparisons of the values of 4 scoring systems were performed among 60 patients: Alvarado, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Tzanakis. Values for the scores were determined in all patients treated with lower right quadrant (LRQ) abdominal pain, under a differential diagnosis of AA. After the appendectomy (open surgery or laparoscopic), a correlation was obtained between the histopathologic findings (HP) and the corresponding latent values. Results. In the study 63.33% of the patients were male. Distribution of patients according to the values of the three different systems (Alvarado, RIPASA and Tzanakis) showed that the largest number of patients had values higher than 8 and AIR values of 7- 8. In the study, 95% of the operated patients were positive for appendicitis compared to the histopathological finding. 80% of the surgeries included on-time appendectomy, 15% delayed diagnosis, and 5% were found to be with an unnecessary appendectomy. According to the HP findings of those with positive findings, 77.2% of the cases had appropriate preoperative ultrasonographic (US) diagnosis. A statistically significant association of the scores with HP findings (promptly phlegmonous, promptly gangrenous, late perforated and unnecessary) was found only for the Alvarado, AIR, Tzanakis, and no statistically significant association was found for the RIPASA score. Conclusion. Scoring systems are useful diagnostic tools for appendectomy indication. Using one or a combination of two or more scoring systems reduces the percentage of unnecessary appendectomies.