Faculty of Medicine
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Item type:Publication, Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Sciendo, 2022-07); Cemal UlusoyAim: To determine and define the advantages of the laparoscopic appendectomy in the treatment of complicated appendicitis by comparing it with the open appendectomy. Material and Methods: In this prospective interventional clinical study we compared the intraoperative data and the postoperative outcome of 77 patients presented with complicated appendicitis, operated with open and laparoscopic appendectomy within a period of 20 months. One surgeon performed all of the laparoscopic procedures and two other senior surgeons performed the open procedures. Results: Operative time was shorter in the laparoscopic group (p = 0.033). Conversion rate was 2.3%. Overall postoperative morbidity was 25.97%. There was one operative revision due to postoperative small bowel obstruction in the laparoscopic group. Appendicular stump leakage occurred in one patient in the open group. One intra-abdominal abscess occurred in the laparoscopic group (p = 0.38). Wound infection occurred only in the open group (p = 0.018). Length of stay was shorter in the laparoscopic group (p = 0.0052). One patient from the laparoscopic group was readmitted. Conclusions: Laparoscopy is a reliable method in the treatment of complicated appendicitis. It offers a shorter operative time, low conversion rate, an acceptable rate of major postoperative complications and a shorter length of stay. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Вредноста на лапароскопската апендектомија во третманот на комплициран апендицитис(2021-06)Introduction Acute appendicitis is defined as acute appendicular inflammation which represents one of the most common surgical conditions that require operative treatment (laparoscopic and open appendectomy). The acute inflamation is represented in two forms: noncomplicated and complicated. The last one is further divided into 4 subgroups: appendicular gangrene, perforation/rupture, periappendicular abscess and secondary diffuse peritonitis. Aim This study measures the value of laparoscopic appendectomy in the treatment of complicated appendicitis through a comparation with the open appendectomy. Preoperative serum levels of Leucocyte count, CRP, total bilirubin, ALT and AST were measured; the intraoperative finding and the operative time were noted. In the postoperative period the following parameters were analyzed: the conversion rate, the correlation between the serum levels of Leucocyte count, CRP, total bilirubin, ALT and AST with the grade of intraoperative finding; overall morbidity (postoperative complications, sterile wound collections, wound infections, intraabdominal abscess occurrence); additional interventions were noted and length of stay was compared between the two groups of patients. Material and methods Operated patients with complicated appendicitis were analyzed in this prospective interventional clinical study conducted in the University Clinic “Sv. Naum Ohridski” – Skopje in the period of May 2019 – February 2021. The patients were operated with standard three-port laparoscopic technique and with the open Mc Burney access. Results Total number of 77 patients with complicated appendicitis were operated (44 laparoscopically and 33 with the open method). Positive correlation of the preoperative serum levels with the intraoperative grade is confirmed as statistically significant only for the values of CRP (p = 0.012). Operative time was statistically shorter in the laparoscopic group (67.4 ± 22.9 min. and 77.9 ± 17.9 min., p = 0.033). Overall morbidity was 25.97%. Postoperative complications occurred in 10 patients in the laparoscopic group (20.8%) and in 10 patients in the open group (30.3%). Wound infection was noted only in the open group (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopic group (p = 0.38). There was one patient with postoperative bowel obstruction in the laparoscopic group (p = 0.38) and one patient with appendicular stump leak in the open group (p = 0.38). Length of stay was shorter in the laparoscopic group (p = 0.00009). Conclusion The method of laparoscopic appendectomy presented statistically significant advantages over the open appendectomy in the treatment of complicated appendicitis in terms of operative time, wound infection and the length of stay. Complicated appendicitis remains unexplored clinical entity that require new research studies in different medical disciplines in the future. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MASTERING THE LEARNING CURVE SIGNIFICANTLY REDUCES OPERATIVE TIME FOR LAPAROSCOPIC TREATMENT OF COMPLICATED APPENDICITIS(INSTITUTE OF PUBLIC HEALTH OF REPUBLIC OF NORTH MACEDONIA, 2021-08-30); ; Laparoscopic appendectomy is the preferred operative method for acute appendicitis treatment. In terms of complicated appendicitis it can be effective in hands of an experienced laparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospective study examines whether the operative time for laparoscopic appendectomy for complicated appendicitis is shortened after mastering the learning curve. Material and methods: A total number of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77 were diagnosed with complicated appendicitis. They were subsequently divided in two groups (laparoscopic and open). Operative time in both groups was measured and the conversion and postoperative complications were noted. Results: Conversion rate was 2.3%. Operative time was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033). Overall postoperative morbidity was 25.97% with wound infection present only in the open group (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopic group (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CORRELATION OF PREOPERATIVE SERUM MARKERS WITH THE GRADE OF COMPLICATED APPENDICITIS(KNOWLEDGE - International Journal, 2021-06-15); ;