Shumkovski, Aleksandar
Preferred name
Shumkovski, Aleksandar
Official Name
Shumkovski, Aleksandar
Alternative Name
Sumkovski , Aleksandar
Sumkovski A.
А.Шумковски
Shumkovski A.
Александар Шумковски
Aleksandar Sumkovski
Aleksandar Shumkovski
Sumkovski Aleksandar
A.Sumkovski
Shumkovski Aleksandar
Шумковски А
Main Affiliation
9 results
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Item type:Publication, Comparison Between Dunking (Invagination) Pancreaticojejunoanastomosis and Double Layer Duct to Mucosa Anastomosis After Cephalic Duodenopancreatectomy-Whipple Procedure for Pancreatic Cephalic Carcinoma(Walter de Gruyter GmbH, 2020-11-01); ; Gjoshev, Stojan<jats:title>Abstract</jats:title> <jats:p> <jats:bold>Introduction</jats:bold>: Pancreatic cancer is malignancy with poor prognosis for quality of life and overall survival. The incidence is variant, 7.7/100,000 in Europe, 7.6/100,000 in the USA, 2.2/100.000 in Africa. The only real benefit for cure is surgery, duodenopancreatectomy. The key points for this procedure are radicality, low morbidity and low mortality, the follow up and the expected overall survival. The benchmark of the procedure is the pancreaticojejunoanastomosis, with its main pitfall, postoperative pancreatic fistula B or C. Subsequently, the manner of creation of pancreaticojejunoanastomosis defines the safety, thus the postoperative morbidity and mortality. Finally, this issue remarkably depends on the surgeon and the surgical technique creating the anastomosis. We used 2 techniques with interrupted sutures, dunking anastomosis and duct-to-mucosa double layer technique. The objective of the study was to compare these 2 suturing techniques we applied, and the aim was to reveal the risk benefit rationale for dunking either duct to mucosa anastomosis.</jats:p> <jats:p> <jats:bold>Material and method:</jats:bold> In our last series of 25 patients suffering pancreatic head carcinoma we performed a standard dodenopancreatectomy. After the preoperative diagnosis and staging with US, CICT, tumor markers, they underwent surgery. Invagination-dunking anastomosis was performed in 15, whereas, duct-to-mucosa, double layer anastomosis was performed in 10. In the first group with dunking anastomosis, we had 6 patients with soft pancreas and 8 with narrow main pancreatic duct, less than 3 mm. In the duct-to-mucosa group there were 5 patients with soft pancreas and 4 with narrow main pancreatic duct. All other stages of surgery were unified, so the only difference in the procedure remained on the pancreatojejunoanastomosis. The onset of the postoperative pancreatic fistula was estimated with revelation of 3 fold serum level of alfa amylases from the third postoperative day in the drain liquid.</jats:p> <jats:p> <jats:bold>Results</jats:bold>: In the duct to mucosa group there wasn’t a clinically relevant postoperative pancreatic fistula, while in the dunking anastomosis group we had 4 postoperative pancreatic fistula B, 26 %. One of these 4 patients experienced intraabdominal collection – abscess, conservatively managed with lavation through the drain. Comparing the groups, there was no significant difference between the groups concerning the appearance of postoperative pancreatic fistula: p>0.05, p=0.125. From all 25 patients, in 21 patients biliary stent was installed preoperatively to resolve the preoperative jaundice. All 21 suffered preoperative and postoperative reflux cholangitis, extending the intra-hospital stay.</jats:p> <jats:p> <jats:bold>Conclusion</jats:bold>: So far, there have been many trials referring to opposite results while comparing these 2 techniques in creation of the pancreticojejunoanastomosis. In our study, the duct to mucosa anastomosis prevailed as a technique, proving its risk benefit rationale. However, further large randomized clinical studies have to be conducted to clarify which of these procedures would be the prime objective in the choice of the surgeon while creating pancreatojejunoanastomosis.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Late Onset of Pancreatic Metastases from Renal Cell Carcinoma. A Case Report(Walter de Gruyter GmbH / Macedonian Academy of Sciences and Arts, 2020-09-01); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE NEW CLASSIFICATION OF DISTAL EXTRAHEPATIC CHOLANGIOCARCINOMA-MORPHOLOGICAL ANALYSIS AND REVIEW OF LITERATURE(MACEDONIAN ASSOCIATION OF ANATOMISTS AND MORPHOLOGISTS, 2011); ; ; ; Extrahepatic cholangiocarcinoma (EH-CCa) is a malignant tumor that arises from the ductal epithelium of the extrahepatic bile duct and it has been divided into perihilar and distal at the level of the cystic duct . As relatively rare disease perihilar and distal extrahepatic cholangiocarcinoma should be viewed as independent entities because of their distinct biology and management. The aim of the study was to make morphologic analysis of archive material of diagnosed EH-CCa at the Institute of pathology, Medical Faculty, Skopje in 5-year period and revision of the cases according to 7th edition (AJCC/UICC) TNM staging classification. We used archive material from the data base of the Institute of pathology, Medical Faculty, Skopje, for 7 cases diagnosed as distal EH-CCA between year 2006 and year 2010. Four analyzed adenocarcinomas showed periductal-infiltrating pattern of growth and 3 cases had massforming characteristics. One case revealed pancreatic involvement, 5 infiltrated the periductal soft tissue and 1 was confined to the ductal wall. In 3 cases peri/intraneural invasion was found and 2 cases had vascular tumor embolusses. There were 2 lymph nodes with metastases from 10 examined in only one case, in two cases there was no surgical resection of lymph nodes, and the rest cases were free from metastatic disease. Positive surgical margines we found in 2 cases and 2 were negative. The most of EH-CCA were diagnosed in stage IB, one was in stage IA and one in stage IIB. The purpose of 7th edition AJCC/UICC TNM staging system is predominantly prognostic and will require additional validation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SMALL INTESTINE INTUSSUSCEPTION DUE TO GASTROINTESTINAL STROMAL TUMOUR IN PREGNANCY: A CASE REPORT(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2022); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ВЛИЈАНИЕТО НА РАНАТА ПЕРОРАЛНА ИСХРАНА ВРЗ ПОСТОПЕРАТИВНОТО ВОСПОСТАВУВАЊЕ НА ЦРЕВНАТА ФУНКЦИЈА ПРИ ЕЛЕКТИВНА КОЛОРЕКТАЛНА ХИРУРГИЈА(Архиви на јавното здравје, 2018-06-15); ; Наталија ЦоклескаЦелта на трудот беше да го утврди влијанието на раната перорална исхрана врз постоперативното воспоставување на цревната функција и пероперативниот морбидитет кај пациентите оперирани од колоректален карцином. Материјал и методи: Во проспективната рандомизирана студија беа вклуче-ни 100 пациенти со колоректален карцином со стандардна предоперативна и оперативна процедура. Пациентите беа поделени на 2 групи: испитувана и контролна и секоја група вклучуваше по 50 паци-енти. Пациентите од испитуваната група започнаа со внес на течности во текот на првите 24 часа по-стоперативно и продолжија со регуларна диета во следните 24-48 часа во зависност од толерантноста кон истата. Пациентите од контролната група започнаа со внес на течности и храна по повлекување на постоперативниот илеус. Се следеше времето до воспоставување на цревната функција, должината на постоперативниот болнички престој, бројот и видот на пероперативните компликации и евенту-алните реадмисии во болница во првите 30 дена постоперативно. Резултати: Меѓу испитуваната и контролната група пациенти немаше значајна разлика во однос на демографските податоци, лока-лизацијата на туморот и типот на операција (p>0,05). Бројот на денови до воспоставување на перис-талтика беше 1,18±0,39 наспроти 2,14±0,53, добивање на гасови 1,90±0,65 наспроти 3,34±1,06 и столица 3,24±1,33 наспроти 5,28±1,83. Овие резултати се сигификантно пониски кај испитуваната група во од-нос на контролната група (p<0,001). Не постоеше разлика во анализата на поединечните компликации, меѓутоа вкупниот број на постоперативни компликации беше сигнификантно помал во испитуваната група: 3 наспроти 10 (p=0,04). Болничкиот престој во испитуваната 7,48±2,47 дена наспроти 9,88±3,66 дена во контролната група беше исто така сигнификантно пократок [Z= -6,16 и p<0,001(p=0,000)]. За-клучок: Раната перорална исхрана кај пациентите оперирани од колоректален карцином го забрзува воспоставувањето на цревната функција со истовремено значајно намалување на пероперативниот морбидитет и болничкиот престој. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HER2 Positive Gastric Carcinomas and Their Clinico-Pathological Characteristics(ID Design 2012/DOOEL Skopje, 2018-07-20); ; ; Hadzi-Manchev, DraganHER2 protein expression in gastric carcinoma, in correlation with existing, acknowledged prognostic factors which include the parameters that determine the TNM stage of the disease, could become the basis for ongoing research in the field of molecular targeted and personalised therapy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EBV Positive Gastric Carcinomas and Their Clinicopathological Characteristics(ID Design 2012/DOOEL Skopje, 2018-10-25); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DEMOGRAPHIC AND PATHOLOGICAL CHARACTERISTICS OF GASTRIC CARCINOMAS – A Three-Year Single Center Experience(Macedonian Association of Anatomists, 2020); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CORRELATION BETWEEN HER2 AND EBV EXPRESSION IN GASTRIC CARCINOMA(Macedonian Association of Anatomists, 2020); ; ; Hadzi-Mancev DIntroduction: The understanding of the etiopathogenesis and the molecular basis of gastric carcinoma will facilitate the development of novel molecular target therapies, which interfere with different signal cascades involved in cellular proliferation, differentiation and survival. The aim of this paper was to determine the correlation between HER2 and EBV expression in patients with gastric carcinomas. Material and methods: Eighty patients with gastric carcinoma surgically treated were included in the study. Data of HER2 protein expression were obtained from the archived histopathological reports of the Institute of Pathology in Skopje. For detection of EBV, immunostainings were performed on tumor tissue and the peripheral nontumor gastric mucosa. Results: The results of this study confirmed a significant association between HER2 and EBV expression (p=0.041). The value of the Spearman correlation coefficient (R = - 0.258) indicated a negative, indirect connection of HER2 and EBV expression, which was confirmed as statistically significant (p = 0.02). The HER2 expression in gastric carcinomas was significantly associated with EBV expression, and the expression of HER2 was significantly more common in EBV negative cancers.