Faculty of Medicine
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Item type:Publication, Perioperative Outcomes of the Laparoscopic Treatment for Colorectal Cancer at the Clinic for Digestive Surgery Skopje, in a 5-Year Interval(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2022); ; ; Colorectal cancer (CRC) is the third leading cause of cancer related death in the world, and its incidence is rising in developing nations. Taking into account the increase in the incidence of this disease, the purpose of this review was to evaluate perioperative outcomes (in the first 30 days after surgery) for laparoscopic treatment of this malignancy, a treatment that is steadily becoming standard of patient care in the world. Our review showed that at the Clinic for Digestive Surgery, from 2015 to 2019, 115 patients with colorectal cancer were treated laparoscopically. The figures show a growing trend during this period. 10% of all colorectal cancers in 2019 were completed laparoscopically. In most cases (88.7%) tumor staging was pT2 and pT3. Perioperative outcomes showed wound infection in 2 patients, pulmonary complications in 1, anastomotic leakage in 1, bleeding in 1 patient, no readmission, and no mortality. The rate of conversion to open access is 5.7%, the operating time was 198 minutes on average, the average number of hospital stays was 9 days, and the average number of extirpated lymph nodes 13. There was no need for blood transfusion. Perioperative results for laparoscopic treatment of colorectal cancer at our institution show a low morbidity and mortality rate in these patients, with a clearly rising number in laparoscopically operated patients each year. Long term results are yet to be seen. Follow up with these patients will provide results later. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Spontaneous omental infarction in an obese young female patient treated with laparoscopy: a case report(Oxford University Press (OUP), 2024-06); ; ; Argirov, IvanPartial infarction of the great omentum is a rare cause of abdominal pain and may present as a surgical emergency. Omental infarction might occur due to its torsion, but cases without obvious cause are reported. Risk factors related to this condition are overweight, obesity, abdominal trauma, recent abdominal surgery, hypercoagulability, postprandial vascular congestion and an increase in intra-abdominal pressure. Because of the condition's rarity, most patients are treated with surgery and the diagnosis is established intraoperatively. Preoperative diagnosis allows successful conservative treatment with analgesics and anti-inflammatory drugs. This case reports a young female patient with class III obesity presented with spontaneous partial infarction of the great omentum treated with laparoscopy. - Some of the metrics are blocked by yourconsent settings
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, Laparoscopically Treated Giant Gastric Bezoar Complicated with Large Ulcer in Young Patient(Vilnius University Press, 2021-12-30); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE ANALGESIC EFFECT OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, Macedonia, 2017-04); ; ; Background: Transversus abdominis plane (TAP) block is a (new) regional anesthetic technique that provides analgesia to the parietal peritoneum, as well as the skin and muscles of the anterior abdominal wall, by introducing local anesthetic into the neuro-fascial plane between the internal oblique and the transversus abdominis muscles. Pain after laparoscopic bilateral inguinal hernia surgery can be moderate to severe and can result in prolonged hospital stay, unanticipated hospital admission and delayed return to normal daily activities. We evaluated the efficacy of TAP block in patients undergoing laparoscopic bilateral inguinal hernia repair in a randomized controlled clinical trial. Material and methods: Sixty patients undergoing laparoscopic bilateral inguinal hernia repair were randomized to undergo standard care (n=30) or to undergo a bilateral TAP block with bupivacaine (n=30). All patients received standard anesthetic, and after induction of anesthesia, the TAP group received an ultrasound-guided bilateral TAP block. Each patient was assessed after operation at 2, 6, 12 and 24 hours after surgery. Results: Bilateral ultrasound-guided TAP block significantly reduced postoperative visual analogue scale (VAS) pain scores at rest and on moving, reduced ketonal and tramadol postoperative consumption and reduced incidence of PONV in the TAP block group after surgery compared to control group. Conclusion: Bilateral ultrasound-guided TAP block provides effective postoperative analgesia during the 24 postoperative hours after laparoscopic bilateral inguinal hernia repair.