Faculty of Medicine

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    PANCREATICODUODENECTOMY: RETROSPECTIVE STUDY OF A SINGLE CENTER EXPERIENCE
    (Department of Anesthesia, Reanimation and Intensive Care Faculty of Medicine, University ”Ss. Cyril & Methodius” Skopje, R. of N. Macedonia, 2023-04)
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    Nedelkovski Dane
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    Panikj Katarina
    Background: Whipple surgery (pancreaticoduodenectomy) is a complex surgery with high postoperative complication rate. We aimed to demonstrate the outcomes and rates of complications from patients who had undergone PD in our hospital. Materials and methods: Medical records of 22 patients, who underwent pancreaticoduodenectomy surgery between November 2018 and December 2022 at Department of Abdominal Surgery, City General Hospital 8th September in Skopje, North Macedonia, were examined retrospectively. Age, sex, localization of the lesion and pathohistological properties and postoperative morbidity and mortality were studied. Results: A total of 22 patients (12 male, 10 female) with a mean age of 63,9 years who underwent pancreaticoduodenectomy were included in the study. Ten patients (45,45%) had pancreatic head malignancies, 7 patients (31,81%) had ampullarry malignancies, 1 patient (4,54%) had duodenal and also 1 patient (4,54%) had common bile duct malignancies. Two of our cases (9,08%) underwent surgery for gastric antrum carcinoma and one patient (4,54%) for colon carcinoma. The most frequently encountered complications were pancreatic fistula (18,16%), biliary leakage (13,64%) and pulmonary complications (13,64%). Surgery related mortality rate was 9,09% (2 cases). Conclusion: We represent outcomes of our surgical team compared to the published data of some other centers. Prospective randomized studies are needed to adequately assess postoperative complications. To improve the postoperative outcome, appropriate monitoring, multidisciplinary approach and further improving of surgical techniques are needed.
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    Comparative Analysis between Laparoscopic and Open IPOM Ventral Hernioplasty
    (International Institute for Science, Technology and Education, 2020-11)
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    Panikj, Katarina
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    Mladenovic, Dragoslav
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    Introduction: In everyday surgical practice, ventral hernia repair is one of the most commonly performed surgeries worldwide. Ventral hernioplasty can be performed either with open or laparoscopic approach and in this study both approaches use the IPOM technique of mesh placement. From the clinical experience so far, the laparoscopic approach is characterized by a lower rate of early postoperative complications, shorter hospital stay and a period of convalescence. The aim of the study was to compare early postoperative complications, duration of surgery, hospital stay, recurrence in the first year and convalescence period between patients undergoing open and laparoscopic access with IPOM ventral hernioplasty. Material and methods: The study was designed as a randomized, prospective, comparative study of 63 patients who met the inclusion criteria, operated by IPOM technique and divided into two groups: open access to 32 patients and laparoscopic access to 31 patients. Early postoperative complications, duration of surgery, hospital stay, recurrence in the first year, and convalescence were compared in both groups. Statistical processing and data analysis was performed in the statistical programme SPSS version 23.0. Values of p <0.05 were taken as statistically significant. Results: Regarding the early postoperative complications, it was found that the occurrence of seroma is more common in the laparoscopic group (p = 0.013), while in open hernioplasty the number of surgical site infections is significantly higher (p = 0.03). The hospital stay expressed in days is longer in open hernioplasty (p = 000001). Regarding the duration of the operation (p = 0.8) and the period of convalescence (p = 0.28), there is no statistically significant difference between the two groups. Discussion: The results shown by our experience shows that laparoscopic ventral IPOM hernia repair is characterized by lower rates of SSI, a shorter hospital stay, but without statistical significant benefit in terms of a period of convalescence, duration of surgery and recidive rate in the first year. Тhe choice of treatment and access should be based according to individual patient characteristics. A laparoscopic approach, due to its minimal invasiveness, should be more common in ventral hernioplasty.