Tanturovski, Mile

Preferred name

Tanturovski, Mile

Official Name

Tanturovski, Mile

Translated Name

Тантуровски, Миле

Main Affiliation

mile.tanturovski@medf.ukim.edu.mk

Now showing 1 - 10 of 30

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FACTORS INFLUENCING THE EARLY POSTOPERATIVE QUALITY OF LIFE IN PATIENTS TREATED SURGICALLY FOR GYNECOLOGICAL MALIGNANCIES
(Macedonian association of anatomists and morphologists, 2019)
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Jovanovska V
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Tanturovski D
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Stojchevski S
ABSTRACT Aim: To evaluate the influence of inherent patient characteristics on early postoperative QoL in patients treated surgically for gynecological malignancies Materials and methods: The study was designed as a prospective cohort study. Patients scheduled for surgical treatment of a gynecological malignancy at the Department of gynecological oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2018. Quality of life was quantified using a standardized and validated questionnaire (FACT-G) preoperatively and 1 month after surgical treatment. We explored the effect of the following variables: age, BMI, nationality, education, marital status, place of residence, employment, primary location of the neoplasm, disease stage, extent of surgical resection, comorbidities and smoking. Results: Data from 123 patients were included in the final analysis. The average age of patients at the time of recruitment was 58±10 years (range 23-79 years). Eighty-four patients (68.29%) had endometrial cancer, 22 (17.89%) patients had cervical cancer, while 17 (13.82%) patients had ovarian cancer. Postoperative FACT-G scores were significantly lower (p=0.015). A clinically relevant postoperative decrease in quality of life was identified in 51 patients (41.5%). Independent predictors of deteriorated postoperative QoL in this study were: advanced disease stage, extensive surgical resection, comorbidities and higher education. Conclusion: The results illustrate the physical, psychological, and social effects of the surgical treatment on the early postoperative QoL, thereby emphasizing the need for a comprehensive, multidisciplinary approach to the pre and postoperative care of these patients.
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Impact of epysiotomy on anal continence in women after vaginal delivery
(Macedonian Association of Anatomists and Morphologists, 2019)
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Lazarova-Stojovska, Aleksandra
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Aim: The purpose of this study to determine the impact of episiotomy use in women after vaginal delivery on the female anal continence Methods: The study was designed as a cross-sectional. It was performed at the University Clinic of Obstetrics and Gynecology, University of "Ss. Cyril and Methodius" in Skopje, Macedonia during a period of one year. The study included 470 women of reproductive age with at least 1 previous vaginal delivery. The following variables were analyzed with regard to their influence on anal continence: use of episiotomy, type of episiotomy, perineal injury and degree of perineal injury. Data was acquired using a questionnaire specially designed for this study. The severity of anal incontinence quantified using St. Mark's Anal Incontinence Score. Results: Both the use of episiotomy and the severity of perineal trauma exerted a significant effect on anal continence. The use of episiotomy has been associated with lower St. Mark’s scores, while higher degrees of perineal trauma, were proven to significantly increase the value of the St. Mark’s score Conclusion: Anal incontinence is an unsettling condition affecting women that is inextricably linked to vaginal delivery. Further studies are needed to prove the benefit of episiotomy, which is traditionally regarded as a protective procedure and a method for prevention of pelvic floor disorders.
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SERTOLI-LEYDIG CELL TUMOR OF THE OVARY AS AN INCIDENTAL FINDING IN A PATIENT UNDERGOING HYSTERECTOMY DUE TO RECURRENT ABNORMAL UTERINE BLEEDING
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023)
Stojchevski, Sasho
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Sertoli-Leydig cell tumor (SLCT) of the ovary is a rare neoplasm that accounts for only 0.5% of all primary ovarian neoplasms. Clinical and histopathological presentations of the tumor are different, which makes diagnosis and treatment difficult. We present a case of a 67-year-old female patient, who presented at the University Clinic for Gynecology and Obstetrics with abnormal uterine bleeding. Explorative curettage was performed for the second time after 1 year, with a histopathological finding of endometrial hyperplasia. The patient underwent an excision of a lung tumor 2 years ago, with a histopathological finding of synovial sarcoma of the lungs, after which she received adjuvant chemotherapy. On transvaginal ultrasonography, the patient had no suspicious pathological findings on the uterus and ovaries. Laboratory tests of tumor markers did not show any elevation. Due to recurrent abnormal bleeding from the uterus, the patient underwent an abdominal hysterectomy with bilateral adnexectomy. Histopathology: Sertoli-Leydig tumor of the right ovary with retiform histoarchitectonics, stage IA and atypical endometrial hyperplasia. Sertoli-Leydig cell tumors have a relatively good prognosis, but their management, surgical treatment and postoperative follow-up due to their rarity is a challenge even today.
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EP778 The role of the E-cadherin/β-catenin signal transduction pathway in the prognosis of advanced stage high-grade serous ovarian/fallopian tube cancer
(BMJ Publishing Group Ltd, 2019-11)
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Introduction/Background The aim of the study was to evaluate the correlation between E-cadherin/β-catenin expression and the clinical and pathological parameters that influence the overall survival rate in patients with advanced stage high-grade serous ovarian/fallopian tube cancer Methodology We performed a retrospective cohort study on patients that underwent primary debulking surgery at the University Clinic of Gynecology and Obstetrics, University ‘Ss. Cyril and Methodius’, Skopje, Republic of North Macedonia between January 2010 and December 2015. The following disease characteristics were analyzed: age, stage, nuclear and tumor grade, lymphovascular invasion, the extent of primary debulking, platinum-based chemotherapy resistance and overall survival. Further, we analyzed the expression of E-cadherin/β-catenin by preforming immunohistochemical staining on deparaffinized and rehydrated tissue specimens with specific monoclonal antibodies. Results A total of 84 patients with primary ovarian and 9 patients with primary fallopian tube cancer met the inclusion criteria. The overall survival of patients in the analyzed cohort was 46 months (95% CI 38–53 months). The residual tumor volume after primary debulking surgery was an independent bad prognostic factor with HR=5.32 (p<0.001). The low frequency of expression as well as the weak staining for E-cadherin were independent bad prognostic factors for the survival of these patients with HR=2.7 (p=0.05) and HR=3.38 (p=0.04), respectively. The univariate analysis also identified that the low frequency of expression and weak staining for β-catenin were bad prognostic factors, but the significance was lost in the multivariate analysis. Conclusion In this study, we identified that the residual tumor volume after primary debulking surgery and the low frequency of expression and weak staining for E-cadherin were independent, statistically significant bad prognostic factors for the overall survival of patients with advanced stage high-grade serous ovarian/fallopian tube cancer. Beta catenin expression was not found to be an independent prognostic factor in the multivariate analysis.
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Influence of obstetrically-associated risk factors in assessing anal incontinence in patients post vaginal delivery
(Macedonian Association of Anatomists and Morphologists, 2018)
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Stojoska Lazarova, Aleksandra
Introduction: Anal incontinence (AI) is an inconvenient and limiting medical condition that can cause social and hygienic problems, isolation, low self-esteem and low quality of life. The etiology is multifactorial. Women are eight times more affected than men and the reason is considered to be childbirth. In order to prevent this social, physical and psychological problem, it is necessary to define the risk factors leading to development of such symptoms in female patients after undergoing vaginal delivery. Factors that influence occurrence of anal incontinence in patients after vaginal delivery, have been categorized into obstetric, maternal and fetal factors. Objective: The purpose of this study is to determine the impact of individual obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery, and express it as anal score value. Materials and methods: We designed the study cross-sectional, and developed the research it at the University Clinic of Obstetrics and Gynecology, "Ss. Cyril and Methodius" University in Skopje, Macedonia, in a 3-month period, from August to November 2017. In this study, we engaged patients in their reproductive age, who had undergone at least one vaginal delivery. The degree of incontinence was determined using St. Mark's Anal Incontinence Score (SMIS). Results: In the examined segments, multi-parity (at least 2 vaginal births) increased by OR = 4.69 (95% CI 2.04-10.82) the patient's risk of having St. Mark’s score of ≥8 and this is statistically significant difference. Induced labor also reduced the likelihood of OR = 0.39 (95% CI 0.15-1.04) for St. Mark’s score of ≥8, but the difference was not a statistically significant one. Use of mediolateral episiotomy had protective significance against the risk of St. Mark score of ≥8. Conclusion: Results of this study show consistency with data published so far on the influence of obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery. Changes in anal incontinence are expressed in increased St. Mark’s score. Our study showed that the following factors had statistically significant impact on the score value: multi-parity, fetal macrosomia and perineal injury (grades 3 and 4).
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Therapeutic Resistance In Synchronous Endometrioid Carcinomas: A Case Report With A Pathogenic Germline Mutation In PMS2
(Elsevier BV, 2025-02)
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The occurrence of synchronous malignancies, particularly endometrial and ovarian cancers, presents a notable clinical challenge, with studies indicating that approximately 2-10% of women diagnosed with ovarian cancer also present with endometrial carcinoma. Mismatch repair (MMR) genes, including PMS2, play a crucial role in the pathogenesis of these cancers, as mutations in MMR genes are associated with increased susceptibility to various malignancies. Understanding these genetic factors is essential for effective treatment approaches.
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The Evaluation of Sentinel Lymph Node Biopsy Using Radiocolloid in First Stage Endometrial Cancer
(Galenos Yayinevi, 2023-06-20)
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Stojchevski, Sasho
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Detection of a sentinel lymph node (SLN) in patients with endometrial cancer (EC) reduces the rate of unnecessary systemic lymph dissection. The aim of this study was to assess the SLN detection rate, accuracy of the method using Tc-99m-SENTI-SCINT and the rate of metastatic nodal involvement in patients with preoperative first stage EC.
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COMBINED SPINAL-EPIDURAL ANESTHESIA FOR ABDOMINAL HYSTERECTOMY IN PATIENTS WITH COPD
(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, 2017-04)
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Ivanov E
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Introduction: All patients with chronic obstructive pulmonary disease (COPD) are with increased risk for intra and postoperative complications during abdominal surgery. In our study we present another approach in anesthetic management in these highly risk patients. Methods: We analyzed 20 patients, ASA III, scheduled for elective abdominal hysterectomy. After appropriate preoperative preparation in every patient epidural catheter was placed on Th12 - L1 or L1-L2 level, while spinal punction with standard spinal anesthesia was performed on lower levels. We evaluate basic hemodynamic parameters, patients’ satisfaction and postoperative pulmonary complications.Results: All hemodynamic parameters showed decrease in the first 30 minutes and then constant flow until the end of surgery. 4 patients developed postoperative pulmonary infection, and ended well. All patients were very satisfied with anesthesia procedure.Conclusion: Combined spinal-epidural anesthesia provides good hemodynamic stability, large patients’ satisfaction with fewer postoperative pulmonary complications in patients with COPD. Encouraging this anesthesia technique might increase the safety margin of surgery in patients with severe pulmonary diseases.
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Factors That Influence Surgical Margin State in Patients Undergoing Cold Knife Conization - A Single Center Experience
(Macedonian Academy of Sciences and Arts / Walter de Gruyter GmbH, 2017-12-01)
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To evaluate the factors that influence the surgical margin state in patients undergoing cold knife conization at the University Clinic of Gynecology and Obstetrics in Skopje, Republic of Macedonia Materials and methods: We have retrospectively analyzed the medical records of all patients that underwent a cold knife conization at our Clinic in 2015. We cross-referenced the surgical margin state with the histopathological diagnosis (LSIL, HSIL or micro-invasive/invasive cancer), menopausal status of the patients, number of pregnancies, surgeon experience, operating time and cone depth. The data was analyzed with the Chi square test, Fisher's exact test for categorical data and Student's T test for continuous data and univariate and multivariate logistical regressions were performed.
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RELATIONSHIP OF IMMUNOHISTOCHEMICAL EXPRESSION OF MISMATCH REPAIR GENE PRODUCTS AND CLINICOPATHOLOGICAL FEATURES IN PATIENTS WITH LOW-GRADE ENDOMETRIAL CANCER
(Macedonian Association of Anatomists and Morphologists, 2024)
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Ognenoska Jankovska, Biljana
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Background: This study examines the relationship between mismatch repair (MMR) gene expression and clinicopathological features in patients with low-grade endometrial cancer (EC). Methods: A prospective cohort of 40 patients with histologically confirmed low-grade EC underwent immunohistochemical analysis to determine MMR status. Clinical data, including age, body mass index (BMI), menopausal status, parity, and comorbidities, were collected. Histopathological evaluations assessed myometrial invasion,lymphovascular invasion and disease stage. Results: MMR deficiency (MMRd) was identified in 35% of patients, predominantly associated with MLH1/PMS2 loss. No significant associations were found between MMR status and clinical characteristics such as age, BMI, or comorbidities. However, MMRd tumors exhibited a significantly higher prevalence of myometrial invasion over 50% (85.71% vs. 38.46%, p=0.0042) and lymphovascular invasion (71.43% vs. 19.23%, p=0.00114). Additionally, MMRd cases were more frequently associated with advanced disease stages, particularly in stage IIIC (28.57% vs. 7.69%, p=0.078). Conclusion: The importance of MMR status in the biological behavior of low-grade endometrial cancer is highlighted in this study. The strong correlation between MMR deficiency and aggressive histopathological features such as increased myometrial and lymphovascular invasion, highlights the need to integrate MMR testing into clinical practice, even if clinical parameters showed no significant association with MMR expression. These results suggest that MMRd may be a useful prognostic indicator that requires more research to improve patient outcomes and treatment approaches for low-grade endometrial cancer.

Tanturovski, Mile

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