Stankov, Viktor

Preferred name

Stankov, Viktor

Official Name

Stankov, Viktor

Translated Name

Станков, Виктор

Alternative Name

Виктор Станков

Viktor Stankov

Stankov, V

V. Stankov

Main Affiliation

viktor.stankov@medf.ukim.edu.mk

Now showing 1 - 10 of 14

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Percutaneous Nephrostomy as a Procedure in the Treatment of Urinary Tract Obstruction - Experiences in the University Clinic of Urology in Skopje
(Macedonian Academy of Sciences and Arts, 2024-04)
Trifunovski, Aleksandar
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Atanasova, Ana
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Obstructive uropathy encompasses various urinary tract obstructions, leading to changes in urine flow, kidney pressure, and impaired kidney function. Predicting renal recovery from obstructive uropathy, can be challenging and necessitates treatment, as in percutaneous nephrostomy (PNS) drainage. The choice of drainage method depends on patient-specific factors and local expertise. According to the data for the Republic of North Macedonia, in the register of the European Renal Association, in the last few years, there has been an increase in the percentage of patients with obstructive nephropathy from 7.6% to 8.9% who end up on a chronic hemodialysis program. Prompt relief from urinary tract obstruction is essential to preserve renal function and prevent complications. The aim of this study is to present our initial data analysis of recent experience in the use of nephrostomies as a method for temporary or long-term resolution of obstructive nephropathy, in terms of safety and success in preserving kidney function and reducing the number of patients on hemodialysis.
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IS REGIONAL POPLITEAL SCIATIC NERVE BLOCK A BETTER OPTION FOR TREATING PEDIATRIC SPORTS INJURIES THAN GENERAL ENDOTRACHEAL ANESTHESIA?
(Faculty of Physical Education, Sport and Health in Skopje, Republic of Macedonia, 2023)
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Ristevski, Toni
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Trifunovski, Aleksandar
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In pediatric anesthesia, the use of ultrasound-guided peripheral nerve blocks has grown in favor. In order to determine the most effective anesthetic technique for pediatric ankle and foot sport procedures, this study evaluated the effectiveness of popliteal sciatic nerve blocks. ASA I or II pediatric patients between the ages of 1 and 14 who had either a localized popliteal sciatic block or general endotracheal anesthesia for surgery due to a sport injury were included in the retrospective analysis. The length of analgesia, the length of recovery, the time until hospital discharge, and any problems that were reported were evaluated. In comparison to general endotracheal anesthesia, popliteal plexus regional anesthesia showed quicker operation times, shorter recovery times, and longer analgesia durations. Additionally, the popliteal plexus anesthetic group's average hospital stay was shorter and there were no problems. Despite several cases of unsuccessful blocks and minor problems in the general anesthetic group, it was clear that popliteal nerve blocks often reduced pain, reduced the need for opioids, increased patient comfort, and sped up recovery. In conclusion, popliteal nerve blocks are a safe, dependable, and effective alternative to conventional anesthetic methods for treating postoperative pain in pediatric ankle and foot procedures.
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Acute fulminant hepatatis in kidney transplant recipient after repeated sevoflurane anesthesia--a case report and literature review
(Bentham Science Publishers Ltd., 2013-04)
Masin-Spasovska, Jelka
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Dohchev, Saso
A liver dysfunction induced by halogenated volatile anaesthetics is considered as a significant diagnostic problem. The aim of our report was to describe the first case of lethal hepatic failure in a female patient undergoing kidney transplantation (KTx) from a living donor after repeated sevoflurane anaesthesia.
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Solitary Fibrous Tumor of Adrenal Gland and Review of the Literature
(Walter de Gruyter GmbH / Macedonian Academy of Sciences and Arts, 2021-12-30)
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Janculev, Josif
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Solitary fibrous tumor (SFT) is a rare and still controversial entity. This type of tumor first appeared in the literature as a pleural lesion, but, over the last decades, it has been reported in many extrathoracic sites. As a tumor of the adrenal gland, SFT is still rare and very uncommon, thus extensive research among the English language literature has been performed. We present here a case report of an adrenal SFT which is compared to 11 other known cases. Our case report is from a patient with SFT on the left adrenal gland, followed by mild symptoms of abdominal discomfort and hypertension. Physical examination, laboratory, and radiological tests were performed. The patient underwent surgery and the material was sent for histopathologic analysis for a definite diagnosis. Regular follow up appointments were performed over the course of two years. No recurrence of the tumor has been detected. We explain the symptoms, diagnosis, treatment, and additionally we describe the results and implications of the findings reported in the literature. Correct diagnosis is mandatory for optimal management of solitary fibrous tumor patients.
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Palpable abdominal mass persisting for a long time: a case report
(Balkan Association of Urology, 2022-09-30)
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Kjamili, Jeton
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Janchulev, Josif
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Introduction: The urachus is the remnant of the connection between the urinary bladder and the allantois. Rarely, the urachus partially obliterates or reopens under pathological circumstances. Pathology of the urachus in adults is rare but often manifests as an acute abdomen, umbilical infection, or fistula. We present a case of inflamed urachus sinus and cyst presenting as a tumorous abdominal mass that infiltrate the nearby organs Case report: A 67-year-old patient was referred to our urology clinic with a complaint of pneumaturia and presence of an abdominal mass for one year. On clinical examination, a palpable painless mass was present suprapubically to the right. There were no skin changes. There were no previous operations, nor more serious chronic diseases. Laboratory tests, including tumor markers, were unremarkable. Computer tomography (CT) revealed air in the bladder and suspected vesicointestinal fistula. A voiding urethrocystography revealed no fistulous channel, but only air in the bladder. A colonoscopy was performed and hypertrophic valvula Bauhini was observed. A cystoscopy with transurethral resection was performed on the abnormal mucosa on the right side of the vertex and histopathological analysis (HPA) revealed chronic cystitis and urachus fragments. The patient was prescribed antibiotic therapy for one month, and there was mass reduction and clinical improvement but no complete resolution. It was decided to proceed with a laparotomy. Total tumor removal with a partial cystectomy, hemicolectomy, also a lymphadenectomy was performed. HPA revealed phlegmonous urachal sinus and urachal cyst with inflammatory changes of the urinary bladder, terminal ileum, caecum, appendix, ascending colon and right ovary. Conclusion: Adult urachal abnormalities are uncommon, yet because of their various clinical manifestations, they are frequently misdiagnosed. Planning the right surgical treatment with the assistance of an early diagnosis helps lower morbidity.
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LAPAROSCOPIC SURGICAL TREATMENT FOR ADRENAL TUMORS, A RETROSPECTIVE ANALYSIS
(Macedonian Academy of Sciences and Arts, 2022)
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Sasho Dohchev
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Sotir Stavridis
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Objective. Laparoscopic adrenalectomy has rapidly replaced open adrenalectomy as the procedure of choice for benign adrenal tumors. The aim of this study was to evaluate the long-term results of 105 consecutive laparoscopic and open adrenalectomies performed during a period of 14.5 years at the University Clinic of Urology in Skopje. We aimed to present our experience with this procedure. In addition, we compare the clinical outcomes of laparoscopic (LA) vs. the open adrenalectomies (OA) performed at our institution. Patients and methods: A retrospective analysis of patients operated on for adrenal tumors was conducted. From May 2005 to August 2020, one hundred adrenalectomies were performed on 105 patients since laparoscopic adrenal surgery was introduced in our country. There were 48 men and 57 women, aged 23 to 73 years. All patients were assessed regarding their demographic data, hormonal status, operative time, estimated blood loss, complications, size of the tumor, number of patients requiring blood transfusion, hospital stay and conversion to open surgery for LA. Results: In 93 patients, the laparoscopic procedure was completed successfully. In 12 cases, the laparoscopic procedure was converted to an open one. Operative time for laparoscopic adrenalectomies ranged from 45 to 120 minutes. The average postoperative hospital stays for laparoscopic adrenalectomy ranged from 1 to 2 days (1.5 days), versus 5 to 20 days for patients who underwent the open or converted procedure. LA proved superior to OA, resulting in less estimated blood loss, shorter operating time, shorter time to resumption of oral intake, shorter postoperative hospital stay and less analgesic requirements. During the follow-up of 3 to 96 months, no tumor recurrence and/or metastasis developed. Conclusions: Laparoscopic adrenalectomy should be the treatment of choice for all benign adrenal tumors. Laparoscopic resection of large adrenal tumors necessitates experience in open and advanced laparoscopic surgery. Our results concur with other retrospective reviews comparing laparoscopic and open adrenalectomy, demonstrating unequivocal advantages in terms of reduced length of hospital stay, blood loss, return of bowel function, functional recovery, and post-operative morbidity
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CORRELATION OF PD-L1 GENE EXPRESSION WITH GRADE OF THE URINARY BLADDER CANCER
(Македонско лекарско друштво = Macedonian medical association, 2023-12)
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Dohchev, Sasho
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Abstract Introduction. Bladder cancer (BC) ranks fourth in the prevalence of malignancies in developed countries and is the eighth leading cause of cancer-related mortality in men. PD-L1, known for its role in inhibiting immune responses against malignant cells, has garnered significant attention in BC research. Methods. This study, comprising 45 patients with histopathologically confirmed urothelial carcinoma of the urinary bladder, analyzed the connection between histological grade and PD-L1 gene expression. The patient cohort was divided into 31 classified as low-grade and 14 as high-grade, with gender and age distribution well-balanced across the groups. PD-L1 expression was notably higher in the high-grade group (p=0.005), showing its potential clinical relevance as a biomarker. Results. Univariate logistic analysis revealed a robust correlation between histological grade and PDL1 expression, with high-grade patients exhibiting a 7.227-fold higher likelihood of increased PD-L1 expression. A predictive model for grade determination demonstrated commendable performance, boasting an area under the curve (AUC) of 0.788. Conclusion. These findings provide compelling evidence of a strong association between PD-L1 gene expression and the histological grade of bladder cancer. PD-L1 emerges as a potential biomarker, shedding light on a disease pathological grade, offering a significant clinical value for precise prognosis, and guiding tailored treatment strategies. These insights hold promise for improved disease management and patient outcomes.
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Is it possible for a metanephric adenoma to mimic renal cell carcinoma preoperatively?
(2022-09-30)
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Kjamili, Jeton
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Janchulev, Josif
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Obturator Nerve Block for Transurethral Resection of Bladder Tumors
(COPE, 2023-03)
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Josif Janchulev
Background: Bladder tumors are identified and treated using a surgical procedure called as transurethral resection of bladder tumors (TUR-BT). During TUR-BT resection, stimulation of the obturator nerve may cause violent adductor muscle spasms. The “obturator reflex,” as this disorder is known, generally causes the legs to move inadvertently (leg jerking). Since this condition can cause several complications, it is preferable to avoid it. Objective: In this study, we investigated the effectiveness of spinal anesthesia combined with obturator nerve block or general anesthetic without muscle relaxant in preventing adductor muscle spasm during TUR-BT procedures. Methods: Forty consecutive patients were enrolled in a prospective observational evaluation and divided into two groups. Patients in Group I underwent spinal anesthesia along with an obturator nerve block, while those in Group II underwent general anesthesia without a neuromuscular relaxant. The following details were recorded: time for obturator block performance, the severity of the motor blockade, the length of the procedure in both groups because a probable adductor spasm might make it more difficult. The level of the surgeon’s pleasure was noted throughout the surgery. Additionally, the patient’s satisfaction and any issues that may have arisen were documented (the incidence of vascular puncture, hematoma, nerve damage, and visceral injury was noted). Results: Block performance time in Group I was 4.8±0.5 minutes, whereas it was 5.0±0.3 minutes in Group II. The ease of access for the two groups was the same. Group I demonstrated increased patient and surgeon satisfaction with a general anesthesia without neuromuscular relaxants and an obturatorius nerve block. Mean surgical time did not differ between the groups.There were no complications in either group. Conclusion: During such operations, routine use of ONB in combination with spinal anaesthetic or general anesthetic without a neuromuscular blocker can enhance oncological outcomes for patients, reduce complication rates, and extend the period of time spent living without disease
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The Role of Erector Spinae Block in Urological Surgeries as a Promising Alternative to Conventional Analgesia: A Prospective Observational Study
(Walter de Gruyter GmbH, 2025-06-01)
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Trifunovski, Aleksandar
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Introduction: The erector spinae plane block (ESPB) is a regional anesthesia technique that provides somatic and visceral analgesia by targeting the dorsal and ventral rami of the spinal nerves. It is performed under ultrasound guidance. ESPB is particularly beneficial in urological surgeries, which often require multimodal analgesia due to complex pain management needs and patient comorbidities. However, its efficacy in urological procedures remains insufficiently studied. Therefore, our aim was to assess the effectiveness and advantages of ESPB in urological procedures. Material and Methods: This prospective observational study was conducted at a tertiary referral hospital. The study included all consecutive patients scheduled for urological surgery, classical approach, or laparoscopic surgery under general anesthesia. Patients were ASA I–III, aged ≥18 years. Exclusion criteria included coagulopathy, infection at the injection site, allergy to local anesthetics, and chronic opioid therapy. ESPB was performed under ultrasound guidance, and a 20G echogenic needle was used to administer 20–30 mL of 0.5% bupivacaine at the Th8–L2 vertebrae level, depending on surgical requirements. The primary outcome, postoperative pain, was measured using a visual analog scale at 2, 6, 12, and 24 hours. The incidence of postoperative nausea and vomiting (PONV), the total amount of opioids consumed in a 24-hour period, and intraoperative hemodynamic stability were the secondary outcomes. IV fentanyl and paracetamol were used for postoperative analgesia, and metoclopramide was used to control nausea. Results: Fifty patients (42 males, 8 females, mean age 66±9.8 years) were analyzed. The majority were ASA II (44%) and ASA III (50%). Open surgeries were performed on 21 patients, while 19 underwent laparoscopic procedures. Primary Outcome: Pain scores (VAS) at 6h, 12h, and 24h were significantly lower in laparoscopic groups compared to open surgeries (p<0.05). Secondary Outcomes: Only three patients (6%) from the open classical approach surgery required rescue opioids. PONV occurred in two patients (4%): one from the open and the other from the laparoscopic approach surgery. Intraoperative hemodynamics remained stable, with no significant fluctuations in MAP or HR. Conclusion: ESPB provided effective analgesia, reduced opioid consumption, and maintained hemodynamic stability in urological surgeries, supporting its role in multimodal pain management strategies.

Stankov, Viktor

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