Now showing 1 - 6 of 6
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Risk Factors for Early Postoperative Complications after Surgery for Crohn's Disease
    (Centre for Evaluation in Education and Science (CEON/CEES), 2014-09-01)
    ;
    ;
    ;
    Milev, Ilija
    ;
    Gelevski, Radomir
    <jats:title>Summary</jats:title> <jats:p> The aim of this study was to show the influence of various risk factors on early postoperative complications following surgery for Crohn’s disease (CD). In this review, an online internet database was searched, and also systematic review of the literature was performed. Three different studies from different countries were analyzed and compared with the results obtained in our University Clinic of Digestive Surgery - Skopje. The first review shows the influence of positive resection margins in CD on septical complications occurrence in patients undergoing ileocolic resection for CD at the Tel Aviv Medical Centre - Israel. The second review shows the risk factors for complications after bowel surgery in Korean patients with CD using data from the Asan Medical Centre - Seul, Korea. The third review shows that the delay of surgery is associated with inferior postoperative outcome in patients treated for perforating Crohn’s ileitis, and the study was conducted using data from the medical records of patients treated at the Department of Surgery at the University of Regensburg, Germany. Finally, we analyzed the influence of the most common risk factors on early postoperative complications in patients that underwent surgery for Crohn’s disease in a five-year period at the University Clinic of Digestive Surgery in Skopje, Macedonia and compared them with the results in the aforementioned articles.</jats:p>
  • Some of the metrics are blocked by your 
    Item type:Publication,
    PREOPERTIVE STAGING OF RECTAL CARNCER WITH MRI
    (Medical faculty, Ss Cyril and Methodius University Skopje, 2018-03)
    ;
    Introduction: Rectal cancer is the third most common malignant disease worldwide with a high mortality rate in developed countries .. The magnetic resonance imaging method p lays a crucial role in the pre-operational staging of the rectal cancer. MR is a modality of choice for rectal cancer staging, which assists the surgeon in achieving negative resection margins. In fact, MR assists the surgeon in the planning of the type of surgical treatment, and also helps to predict the response to treatment and disease detection. Material and Methods: 61 patients '\lith c'olonoscopy proven rectal cancer have been treated treated with pre-ope_rative 1.5 T MRI of small pelvis in standard planes and pulse sequences (SAG T2, AX Ti, T2, DWI, COR STIR) Results: A tabular presentation of the results is given witch conelated the preoperative MR T staging with the pathohistological finding. The comparison was made in Tl, T2, T3 and T4 MR stadium with the acquired pathohistological stadium. The second table showing a percentage view of the difference between MR preoperative stadium and pathohistological results. Also a tabular presentation with general infom1ation for patients is given ; gender , nationality and age. Conclusion: MR as an ideal imaging method for preoperative staging for a local or advanced stage of rectal cancer. MR allows evaluation of extramural spreading, determines the mesorectal involvement and involves the margin of resection.
  • Some of the metrics are blocked by your 
    Item type:Publication,
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Retrorectal dermoid cyst manifested as an extrasphincteric perianal fistula - case report
    (2014)
    ;
    Milev, I
    ;
    ;
    Retrorectal tumors are very rare but well defined pathological entities in the literature. Also, an extrasphincteric fistula is a very rare form of perianal fistula which makes our case a very unusual and rare one, especially by the fact that it was successfully treated with the first operation and without protective stoma formation. The patient was first treated in hospital for a retrorectal abscess that had spontaneously ruptured in the postanal space. Because of the constant drainage of the suppurative content from the postanal opening in the following months, MRI and fistulography were performed, registering cystic formation in the retrorectal space with fistulous communication with the rectum above and completely separate from the sphincter mechanism. After that the patient was admitted for definitive treatment. The operation was performed with the patient in a prone jack-knife position. Complete excision of the cyst with the fistulous communication was performed and the rectum was sutured in two layers with separate slowly absorbable sutures. The wound was laid open and the patient was discharged on the 5th post operative day. After about ten months the defecation is normal, the wound is sealed and there are no signs of inflammation and secretion locally.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    IMPORTANCE OF EXTRAMURAL VASCULAR INVASION IN PREOPERATIVE STAGING OF RECTAL CANCER WITH MRI
    (Македонско лекарско друштво = Macedonian medical association, 2018-03-03)
    ;
    Introduction. Rectal cancer is the third most common malignant disease worldwide with a high mortality rate in developed countries. The prognosis of rectal cancer has been significantly improved over the past decade, and this is mainly due to progress in preoperative staging, which has been reflected in the therapeutic approach, where a significant change was made from simple surgical treatment to multimodal treatment. Although extramural vascular invasion (EMVI) is not included in the classical protocol for preoperative staging, itis a significant prognostic indicator of the recurrence rate. Methods. The study is a prospective one, and it included 61 hospital patients with previously proven rectal cancer, who had been operated on at the Department of Abdominal Surgery ofthe University Clinic for Surgical Diseases “St. Naum Ohridski” in Skopje, and who underwent a magnetic resonance staging preoperatively. Results. Comparison of extramural vascular invasion determined with MR preoperatively with pathohistological postoperatively obtained result. Conclusion. MR as an ideal imaging method in preoperative staging of rectal carcinoma. It is a tool that determines with high accuracy the extramural vascular invasion in patients with rectal cancer.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Presacral, Retrorectal Dermoid Cyst in a Female Patient - Case Report
    (2012-10)
    ;
    ;
    Milev, Ilija
    ;
    The retrorectal tumors are well defined, classified and understood pathological entities in the literature but in practice they represent very unusual and infrequent pathology. We are presenting a case from the group of dermoid congenital retrorectal cysts which at first manifested itself clinically as inflamatous retrorectal cyst that had spontaneously rupture in the postanal space with local (tumor, dolor, calor, rubor, function laesa and fluctuation) and systemic signs of infection (fever, rise temperature, leukocytosis). On physical examination there was typical postanal dimple which gives a picture of “double anus” on inspection. On DRE there was retrorectal soft tumor with compression of the anorectum. Diagnosis was confirmed with MRI and fistulography. After a palliative treatment for abscending cyst with incision, Penrose drainage and daily washings with antiseptic solutions the patient was transferred in specialized institution - the Clinic of Digestive surgery at the Medical Faculty in Skopje for definitive treatment. The operation was performed with the patient in jack-knife position with conventional preparing of the colon and prophylactic antibiotic regiment started preoperatively. An on table anoscopy was performed at first which sowed typical mammilla at the internal opening of the fistulous communication of the cyst with the rectum about 3 cm above the posterior crypt of Morgagni. We started with excision of the external opening, and preceded with whole excision of the pericystic granulomatous tissue about 14 cm in length till the presacral point. The fistulous communication was excised completely and the rectum was sutured in two layers with separate sutures. The wound was laid open and the patient was discharged on the 5-th postoperative day. About one month the wound was treated with daily washings with antiseptic solutions and after that one month with only water. After two mounts the defecation is normal, the wound is sealed and there are no signs of inflammation and secretion locally. The retrorectal tumors are difficult for treatment as well as for diagnosis where even punctional biopsy is not recommended so they should be treated in specialized institutions by experienced surgeons from the moment of diagnosis to the definitive surgical treatment.