Lazova, Evgenija
Preferred name
Lazova, Evgenija
Official Name
Lazova, Evgenija
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Item type:Publication, PERFORATED ANASTOMOTIC MARGINAL ULCER POST ROUX-EN-Y GASTRIC BYPASS SURGERY: A CASE REPORT(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2022); ; ; Panikj, KatarinaAmong the techniques available for bariatric surgery, Roux-en-Y gastric bypass is safe and effective option. However, it may present with some complications such as marginal anasomotic ulcers, which can perforate and become serious surgical emergency. We present a case of 28-year-old female patient, with abdominal pain and vomiting with clinical presentation of diffuse peritonitis, radiological presentation of pneumoperitoneum and medical history of RYGB 3 years before, with suspected perforation after initial medical assessment and examination. Upper medial laparotomy was performed with large amount of fibrinopurulent content presented in abdominal cavity and perforated MU at medial anastomotic site. It was closed with omental patch, after thorough abdominal irrigation. The patient was discharged on the 10th day after surgery. One of the most common long-term complications after RYGB is the occurence of peptic ulcers and anastomotic stenosis. The main manifestation of untreated MU is perforation, which is urgent surgical and life-threatening condition. The perforated marginal ulcer is a complication of the RYGB procedure in bariatric surgery and is an acute surgical condition. Thorough irrigation of abdominal cavity and omentoplasty of the ulcer lesion is a safe and effective treatment of choice and it gives a good postoperative outcome. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREDICTABILITY OF D-DIMER LEVEL ON ADMISSION FOR HOSPITAL OUTCOMES IN HOSPITALIZED PATIENTS WITH COVID-19 PNEUMONIA(University Ss. Cyril and Methodius in Skopje, 2022); ; ; Meshkova, IskraThe aim of this study was to evaluate the role of D-dimer as a biomarker in the assessment of COVID-19 prognosis in hospitalized patients. Material and methods: A total of 117 patients with confirmed COVID-19 pneumonia between the age of 19 and 89 years (mean age 53) were admitted to the City General Hospital 8th September, Skopje, Macedonia. In all patients, a D-dimer test for coagulation profile and lactate dehydrogenase (LDH) for disease progression were performed on the day of admission. Patient demographic data, presence of comorbidities, severe symptoms, and radiological findings were determined for each patient. We calculated the National Early Warning Score (NEWS 2) for assessment of acute illness severity. The level of oxygen saturation (SpO2) was also determined. Length of hospital stay and length of stay at home were filled later after hospitalization using medical records. Results: Patients were classified according to D-dimer level into a low group (D-dimer ≤ 2 mcg/ml) and a high group (D-dimer ≥ 2 mcg/ml). Elevated D-dimer level was associated with severity, hypoxia, and lethal outcome. Patients with a high level of D-dimer had a higher NEWS 2 score, worsen radiological findings, and higher LDH. Patients with low levels of D dimer stayed at home longer than those with higher D-dimer levels. Conclusion: The D-dimer level is a useful marker in assessing the coagulation profile of patients with COVID-19 pneumonia regardless of the type of disease. Implementation of screening tools like the NEWS 2 score is also needed for better risk stratification on hospital admission. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MALIGNANT DUODENOCOLIC FISTULA- CASE REPORT OF RARE COMPLICATION OF COLONIC CANCER TREATED BY MULTIVISCERAL RESECTION(Macedonian Association of Anatomists, 2022); ; Panikj, KatarinaDuodenocolic fistulas created by invasive cancer of the colon are rare complications. They are presented with serious electrolytic and nutritional disturbances due to vomiting, diarrhoea, abdominal pain, GI bleeding, and weight loss. In this paper, we present young male patient with malignant duodenocolic fistula between ascendant colon and D2 portion of duodenum and pancreatic head, treated with right hemicolectomy and pancreaticoduoedenectomy. Postoperative histopathology confirmed poorly differentiated colonic adenocarcinoma without spreading to lymph nodes and major vessels. Patient is still alive after three years of the operation which led as to conclusion that this type of radical operation may represent one of the best treatments for this rare complication, provides good quality of life and is prognostically justifiable. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Аcute Mesenteric Ischemia and Intestinal Necrosis in COVID-19 Patient: Report of a Case(OA Academic Press, 2023-02); ; Panikj KatarinaAims: We present a case of acute intestinal necrosis due to multiple thrombosis in a female patient with confirmed SARS (Severe Acute Respiratory Syndrome)- Cov 19 infection. Presentation of Case: A 69-year-old female patient was administred in Emergency Department in our hospital with symptoms of general weakness, loss of apetite and elevated body temperature up to 38° C which started three days before the admission, followed by abdominal distension with pain and confusion. After clinical examination and diagnostic investigations, an emergency laparotomy was performed, which showed discontinuos gangrenous changes in terminal ileum, two of which were already perforated, signs of diffuse stercoral peritonitis, spleen with changed morphology (whitish patces and uneven capsule). Resection of the terminal ileum with ileostomy and splenectomy were performed. Discussion: Acute intestinal gangrene is a rarer, but devastating complication in patients with SARS Cov 19 infection. Its first symptoms cannot always be confirmed by diagnostic investigations, so great caution is required. Conclusion: Life-threatining, extrapulmonary complications should be considered in COVID 19 confirmed patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of the Intensity of Postoperative Pain Between Open and Laparoscopic Access of Ventral Hernioplasty with IPOM (Intraperitoneal Onlay Mesh) Technique(2020-09); ; Nanceva JasminkaIntroduction: Despite the numerous advantages of laparoscopic ventral hernioplasty over the open access hernioplasty, described in the literature, the general clinical experience is that patients have severe pain in the first few days, hence early postoperative pain is a challenge in this procedure.The aim of this study was to compare early postoperative pain and whether there was statistically significant difference in the intensity of postoperative pain among patients operated with open and laparoscopic approach with IPOM hernioplasty during resting and activity.Material and methods: A randomized, prospective, comparative study was performed on 63 patients who met the inclusion criteria, operated with the IPOM technique and divided into two groups: open access in 32 patients and laparoscopic approach in 31 patients. In both groups, postoperative pain was compared at eight time intervals during rest and activity, quantified using VAS. The statistical processing and analysis of the data was done in the statistical programme SPSS version 23.0.Results: The results of the study showed that at rest and activity, patients in both groups had significantly different pain intensities on the day of the intervention, the first and second day after the intervention (p<0.0001). At these time points, the intensity of pain was significantly stronger in patients undergoing laparosopic hernioplasty. On the third and seventh postoperative days, as well as one and six months after the intervention, there was no significant difference in pain intensity between the two methods during rest and activity.Discussion: The general clinical experience confirmed in our study is that patients after laparoscopic ventral hernioplasty suffer from severe pain in the early postoperative period and it is the biggest challenge and problem after these operations. The explanation is that it is the result of transfascial sutures for mesh fixation in both groups and additionally multiple lesions of the parietal peritoneum in the laparoscopic method due to the numerous fixations of the mesh with tackers. Future research should focus on developing new non-traumatic methods for mesh fixation (Fibrin Glue) and studies that will analyse in detail the impact of postoperative pain on quality of life. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, POSTOPERATIVE PAIN AFTER VENTRAL HERNIA REPAIR: A PROSPECTIVE COMPARISON OF OPEN VERSUS LAPAROSCOPIC WITH INTRAPERITONEAL ONLAY MESH (IPOM) TECHNIQUE(Macedonian Association of Anatomists, 2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparative Analysis between Laparoscopic and Open IPOM Ventral Hernioplasty(International Institute for Science, Technology and Education, 2020-11); ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SURGICAL MANAGEMENT OF DUODENAL GASTROINTESTINAL STROMAL TUMOR IN A YOUNG ADULT FEMALE PATIENT: A CASE REPORT(Department of Anesthesia, Reanimation and Intensive Care Faculty of Medicine, University ”Ss. Cyril & Methodius” Skopje, R. of N. Macedonia, 2023); ; Panikj KatarinaBackground: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms. They can arise anywhere in digestive tract in adults and only in fewer than 5% of cases can be located in duodenum. Case presentation: We report on a rare case of duodenal GIST in 32-year-old female patient with several comorbidities (extreme obesity, HTA, glucose intolerance) and previous left adrenalectomy. The tumor mass was located in D2 portion of duodenum involving the papilla of Vater, with diameter of 5 cm. It was diagnosed with upper GI endoscopy, abdominal US and CT scan and confirmed histologically as GIST. The optimal surgical approach in this case was pancreaticoduodenectomy (en bloc resection) due to location and size of the tumor and involving the adjacent anatomical structures. R0 resection was confirmed with negative surgical margins. Postoperative course was prolonged due to respiratory complications and present pancreatic fistula. The patient was discharged from hospital in good health condition. Conclusion: There is lack of consensus about appropriate surgical approach in these tumors, due to its rarity. Optimal surgical strategies for duodenal GISTs remain to be established.