Faculty of Medicine

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Author: search.filters.author.Mitevski, AleksandarStart date: 2020

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    EARLY AND LATE COMPLICATIONS OF NASAL FRACTURES IN THE PEDIATRIC POPULATION
    (Macedonian Association of Anatomists and Morphologists, 2026-05-22)
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    Kamshikoski, Igor
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    SUBGLOTTIC STENOSIS AFTER PROLONGED INTUBATION: CASE REPORT AND MANAGEMENT
    (Macedonian Association of Anatomists and Morphologists, 2026-05-22)
    Petreska Dukovska Vesna
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    Blagoj Kocev
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    Kamshikoski, Igor
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    Mitevski, Aleksandar
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    Chemical ablation as successful alternative for treatment of incompetent perforators
    (Македонско лекарско друштво = Macedonian medical association, 2023-12)
    Cvetanovski, Vlatko
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    Cimjescikj, Dina
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    Arsovski, Andreja
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    Mitevski, Aleksandar
    Introduction. Superficial venous incompetence (SVI) is the most common cause of lower extremity superficial venous reflux and varicose veins; nonetheless, incompetent perforator veins (PVs) are the most common cause of recurrent varicose veins after treatment, often unrecognized. Current minimally invasive treatment options include ultrasound-guided sclerotherapy (USGS), endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources, subfascial endoscopic perforator surgery (SEPS) and the relatively new chemical ablation procedure using cyanoacrylate adhesive, which we chose as our primary treatment option for this study, using and comparing the results of two different adhesives. Methods. A retrospective review of a prospectively managed database of chemical ablation as perforator vein treatment performed at a single institution from September 2023 to March 2024 was conducted. The indications for PV treatment were >4 mm in diameter and reflux of >500 milliseconds upon leg compression. Results. A total of 32 patients and 49 limbs presenting PV insufficiency (coexisting with GSV insufficiency in 19 patients) were divided into 2 groups of 16 patients, each group based on the chosen chemical ablation adhesive - VenaBlock and VenaSeal. The VenaBlock group had PV closure rate of 100% immediately intraoperative, at 3 days, 2 weeks, 3 weeks and 1 month from the procedure for each treater perforator. From the VenaSeal group, 13 patients had immediate and continuous treatment success during the follow-up, while in 3 patients there was intraoperatively registered treatment failure (P=0.0127). Conclusion. We find the chemical ablation procedure to be safe and effective for PVs, specifically in the case of using rapid polymerization adhesive. Due to its simplicity and short procedural time, we consider this to be the procedure of choice in case of multiple incompetent PVs present, as well as in significant PV tortuosity.
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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.