Faculty of Medicine
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Item type:Publication, LAPAROSCOPIC VERSUS OPEN KASAI PORTOENTEROSTOMY FOR BILIARY ATRESIA: A SYSTEMATIC REVIEW AND META-ANALYSIS BY THE PEDIATRIC SURGERY META-ANALYSIS STUDY GROUP (PESMA)(European Society of Paediatric Endoscopic Surgeons, 2025-10) - Some of the metrics are blocked by yourconsent settings
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, GIANT LEFT HEPATIC CYST WITH GASTRIC OUTLET OBSTRUCTION(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2025-04); ; The prevalence of cystic hepatic lesions in the United States is estimated to be 15%-18% and simple hepatic cyst is the most common, found in 2.5%-18% of the population. Gastric outlet obstruction (GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach. Individuals with GOO will often have recurrent vomiting of food that has accumulated in the stomach, but cannot pass into the small intestine due to the obstruction. A 74-year-old patient was admitted to the emergency department due to diffuse abdominal pain, bloating and tenderness in the upper abdomen. In the last month, he had malaise, bloating (especially after a large meal), loss of appetite, regurgitation and a metallic taste in the mouth. Laboratory tests (WBC 12.000, CRP 10) and a CT scan of the abdomen with contrast were performed. We detected a multiple cystic formations on the right liver lobe and larger one on the left liver lobe that compresses the antro-pyloric part of the stomach and D-1 of the duodenum. We performed gastric emptying with a nasogastric tube, serological tests to exclude possible echinococcosis and tumor markers to exclude possible malignancy. Then, we performed a diagnostic gastroscopy and the findings were normal. An indication for laparoscopic intervention has been made and laparoscopic evacuation and excision-reduction of the simplex cyst was performed. The histopathological analysis revealed a simplex cyst. The patient had a normal postoperative course and was discharged home on the third postoperative day. At the examinations after 1 and 3 months, the findings were normal. Large cysts within the liver parenchyma are in contact with the vascular, biliary and digestive systems. The resulting compression may lead to inferior vena cava obstruction, Budd Chiari syndrome, obstructive jaundice, portal hypertension and Gastric Outlet Obstruction. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, LAPAROSCOPIC INCISIONAL HERNIA REPAIR IN OBESE PATIENT: A CASE REPORT(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2013); ; Inoduction. Laparoscopic repair of ventral-incisional hernia is increasing compared to open technique. It has become a safe method, with low complications and cost comparable with open techniques. Shorter recovery and length of hospital stay are also associated with laparoscopic repair, especially among obese patients. Case report. We present a case of a 42-year-old patient with BMI (Body Mass Index) of 44. He has had three previous open operations for incisional hernia, the last one being two years ago. We performed a laparoscopic IPOM (Intraperitoneal Onlay Mesh) repair with composite mesh using transfascial (transabdominal) sutures and tacks (staples). Conclusions. Low rate of conversion, minimal perioperative morbidity and low recurrence indicate safety in obese and morbidly obese patients treated with laparoscopic approach. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EFFECT OF BILATERAL ERECTOR SPINAE PLANE (ESP) BLOCK ON PAIN AFTER LAPAROSCOPIC VENTRAL HERNIA REPAIR: A CASE SERIES(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023); - 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, Laparoskopna radikalna cistektomija sa ekstrakorporalnom derivacijom urina - početno iskustvo i preliminarni rezultati(Okruzna podružnica SLD Leskovac, 2020); ; SUMMARY Introduction and objectives: To report our experience with laparoscopic radical cystectomy (LRC) and extracorporeal urinary diversion for muscleinvasive bladder cancer. We have evaluated and summarized the surgical outcomes and complications of this procedure. Patients and methods: We have evaluated retrospectively all patients who underwent LRC at our clinic over a one year period. In all patients, ureteroileocutaneostomy (Bricker technique) was performed for urinary derivation. We have analyzed the following parameters: patient demographic data, laboratory data, intraoperative fluid volume, estimated blood loss and transfusion requirements. Respiratory parameters including arterial blood gas data, anesthesia time, surgical time, time of oral intake, admission to ICU (intensive care unit), hospital stay and any adverse events during the whole period of hospitalization were also analyzed. Results: Patients had similar demographic characteristics. Estimated intraoperative blood loss was 392 ml. Due to prolonged surgical time and CO2 pneumoperitoneum, hypercapnia was observed in 3 patients. Patients had a short period of bowel dysfunction and rapid shift from parenteral to oral nutrition, short hospital stay and low rate of surgical compilations. Conclusion: The results of our study have shown that laparoscopic radical cystectomy is a safe, feasible, and effective alternative to open radical cystectomy. Ex tra cor - po real urinary diversion through a small incision decreases the operating time, while maintaining the benefits of laparoscopic surgery. However, some larger prospective evaluation is to be made for summarizing the overall conclusions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Androgen Secreting Steroid Cell Tumor of the Ovary Represented with Postmenopasal Bleeding and Extensive Hirsutism(Scientific Foundation SPIROSKI, 2013-12-15); ; ; Introduction: Steroid cell tumors of the ovary present less than 0.1% of all ovarian tumors and belong in the group of sex cord-stromal tumors. Case description: We present a case of 69-year-old woman investigated because of postmenopausal bleeding, a 5-year history of excessive hirsutism, baldness and acne. The evaluation revealed elevated serum testosterone, but ultrasound detected a 2 cm mass of the left ovary. The patient underwent hysterectomy and bilateral adnexectomy. The histopathology diagnosis was steroid cell tumor, not otherwise specified. Postoperative chemotherapy was administered at the discretion of the radio-oncologist. At the last follow-up 48 months after surgery, the hirsutism was completely resolved, the serum testosterone was within the normal range and there was no evidence of recurrence. Conclusion: In adult patients with hirsutism and elevated serum testosterone a possibility of a presence of an ovarian steroid cell tumor should be considered. Surgery is the main treatment of such patients. - 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);