Faculty of Medicine
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Item type:Publication, Divestment–Adventitia Resection in Order to Decrease Morbidity and Mortality and Improve R0/R1 Ratio in Curative Pancreatoduodenectomy for Advanced Pancreatic Head Carcinoma(Scientific Foundation Spiroski (publications), 2026-06-14); ; ; Kolari, ArbijonAbstract BACKGROUND: Pancreatic head carcinoma (PHC) is a highly aggressive malignancy associated with substantial morbidity, mortality, and poor long-term survival. Achieving an R0 resection margin during pancreatoduodenectomy (PD) is crucial for improving oncological outcomes. However, in borderline resectable (BRPHC) and locally advanced pancreatic head carcinoma (LAPHC), arterial involvement often necessitates complex arterial resections associated with high perioperative risks. Periarterial sub-adventitial divestment has emerged as a potential alternative to arterial resection, aiming to improve radicality while reducing complications. AIM: To evaluate whether sub-adventitial arterial divestment during curative pancreatoduodenectomy decreases perioperative morbidity and mortality and improves the R0/R1 resection ratio in patients with BRPHC and LAPHC. METHODS: A retrospective study was conducted on 50 consecutive patients with BRPHC or LAPHC treated between 2009 and 2017 following neoadjuvant therapy when indicated. All patients underwent extensive pancreatoduodenectomy with triangle operation, extended lymphadenectomy, and periarterial sub-adventitial divestment of the superior mesenteric, common hepatic, and/or celiac arteries. Clinicopathological data, perioperative morbidity, mortality, length of hospital stay, and R0/R1 resection status were analyzed. RESULTS: Among the 50 patients, 27 (54%) were male and 23 (46%) were female, with a mean age of 63.1 ± 8.97 years. Overall mortality was 8% (4/50). Major complications included postoperative pancreatic fistula (24%), postoperative biliary fistula (2%), postpancreatectomy hemorrhage (4%), reoperation (6%), necrotizing pancreatitis (4%), thromboembolism (4%), cardiac failure (2%), and pulmonary complications (8%). Venous resection was required in 12% of patients. Postoperative pain relief was achieved in 92% of cases. Mean hospital stay was 10.56 ± 6.09 days. Histopathological examination demonstrated R0 resection in 28 patients (56%) and R1 resection in 22 patients (44%). Morbidity and mortality rates were comparable to standard PD and appeared lower than those reported for PD combined with arterial resection. CONCLUSION: Sub-adventitial arterial divestment during pancreatoduodenectomy is a feasible and safe technique for selected patients with borderline resectable and locally advanced pancreatic head carcinoma. The procedure provides acceptable morbidity and mortality rates while achieving favorable R0 resection outcomes, representing a promising alternative to arterial resection in specialized high-volume centers. Keywords Pancreatic head carcinoma Pancreatoduodenectomy Arterial divestment Borderline resectable pancreatic cancer R0 resection - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Education for Radiological Technologists and Their Place in Mammography Diagnostic Methods(Egitim Danismanligi ve Arastirmalari (EDAM), 2015-05-10) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Morphological and Functional Changes in Schoolchildren with Bad Posture(Scientific Scholar, 2016-12) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Goodpasture Syndrome Diagnosed One Year And A Half after the Appearance of the First Symptoms (Case Report)(Scientific Foundation Spiroski (publications), 2016-12-06); ; BACKGROUND: Goodpasture syndrome was originally described as an association of alveolar haemorrhage and glomerulonephritis. It occurs when the immune system attacks and destroys healthy body tissue. AIM: We are presenting a patient with a clinical picture of pulmonary haemorrhage and glomerulonephritis, which is diagnosed by renal biopsy. CASE PRESENTATION: His illnessbegan a year and a half before being diagnosed. In that period he had occasional exacerbations. He was received at our Clinic in extremely serious condition, and after stabilisation of his medical condition, there was made a biopsy of the kidney. The p-ANCA was 8.93 U/ml (neg < 3, poz > 5 U/ml). Histopathological diagnosis of biopsy of the kidney was: Glomerulonephritis extra capillaries focalis, segmentalis et globalis. Based on this he was diagnosed with Goodpasture syndrome. He received corticosteroid therapy and cyclophosphamide, with good response to treatment, and he is currently in a stable condition, receiving only corticosteroid therapy. CONCLUSION: Goodpasture syndrome is a severe illness caused by the formation of antibodies to the glomerular basement membrane and alveolus with consequential damage to renal and pulmonary function. With current therapy, long-term survival is more than 50%. Keywords: alveolar haemorrhage, glomerulonephritis, immune system, anti-glomerular basement membrane (anti-GBM) antibodies, Goodpasture syndrome - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FOOD ALLERGEN SENSITIZATION AND IGE PROFILES IN CHILDREN WITH ATOPIC DERMATITIS: A CROSS-SECTIONAL STUDY(Faculty of Medicine, Ss Cyril and Methodius University in Skopje, 2026-06-18); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IN VITRO ACTIVITY OF CEFTAROLINE AGAINST GRAM-POSITIVE BACTERIA AND ENTEROBACTERALES WITH EMPHASIS ON MRSA: A SINGLE-CENTER STUDY(Faculty of Medicine, Ss Cyril and Methodius University in Skopje, 2026-06-18) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DECREASING OF NEONATAL MORTALITY AT UNIVERSITY GYNECOLOGY AND OBSTETRICS CLINIC IN SKOPJE OUR MATERIAL(Macedonian Association of Anatomists and Morphologists, 2026-02-23); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Pulmonary Thromboembolism Related to Complicated Knee Surgery. Initial Hospital Treatment and 1 Year Follow Up (Case Report)(SASPR Edu International Pvt. Ltd, 2026-08-22); ; Hussain, NazimAbstract Introduction: Pulmonary thromboembolism (PTE) and Deep vein thrombosis (DVT) are common complication following any type of surgery. Orthopedic surgeries have a risk higher than 10% of developing PTE. Therefore, a 2 to 5 weeks is given after the surgical procedure. The aim of this study was to present a case of PTE, preceded by local DVT, preceded by orthopedic surgery despite of prophylaxis with 4000 I.U of LMWH for 21 days and the 1year outpatient follow up afterwards. Materials and methods: A full clinical analysis of a 20 years-old male athlete treated for PTE, DVT and Pleuropneumonia from 22.06.2024 to 05.07.2024 in inpatient setting and a follow up treatment in outpatient setting for 1 year. Results: The patient was admitted with d-dimer count of 3900ng/L, S1Q3T3 ECG pattern highly suspected of underlying PTE. What followed was 2 week long inpatient treatment and stabilization and 1 year-long outpatient treatment, evaluation and finally permanent discontinuation of anticoagulant therapy. Discussion: In an inpatient setting the treatment with LMWH is safer than any other type of anticoagulation for PTE when the right conditions are met and no imminent hemodynamic instability is present. DVT and PTE remain common complications of surgeries especially orthopedic ones. Conclusion: This case highlights the importance of circulatory complications related to surgeries, especially orthopedic ones and how sometimes the given prophylaxis can fail. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A Giant Eustachian Valve Protruding Into the Right Ventricle: A Case Report(Medknow, 2014-05-21); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of the effects of the local anesthetics on immunity during mastectomy(Aga Khan University Hospital, 2024-02-05); ; ; ; Kishman, Aleksandar