Pejkov, Risto

Preferred name

Pejkov, Risto

Official Name

Pejkov, Risto

Translated Name

Пејков, Ристо

Alternative Name

Pejkov, R

Ристо Пејков

Risto Pejkov

Main Affiliation

Now showing 1 - 10 of 16

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Laparoscopic cystoprostatectomy - a feasible option in South-Eastern Europe?
(Elsevier BV, 2018-10)
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Gurmeshevski, S.
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Shabani, B.
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MANAGEMENT OF HUGE PROSTATE ABSCESS IN A YOUNG PATIENT - A CASE REPORT
(Македонско лекарско друштво=Macedonain Medical Association, 2020)
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A prostate abscess is a localized collection of purulent fluid within the prostate, which is often seen as a complication of acute bacterial prostatitis. A 20-year-old patient presented with a 14-day history of increased urinary frequency, dysuria, fever, left gluteal pain and obstipation. The patient claimed that he was not sexually active and did not have any chronic diseases or history of surgical procedures. The digital rectal examination was painful and a firm tumefaction with smooth wall was found. Complete blood count with differential was made and it showed elevated inflammatory markers (WBC- 28 x10^9/L, CRP-220 mg/L). An abdominal ultrasound and pelvic MRI scan revealed a cystic lesion 49x67x94 mm found in the prostate. A needle was inserted inside the lesion via transrectal ultrasound (TRUS), and 95 ml of purulent drainage was aspirated. The patient was treated with broad-spectrum intravenous antibiotics – ceftriaxone and ciprofloxacin. The symptoms disappeared immediately after the procedure. Microbiological culture from the purulent specimen was made and it was positive on Peptococcus, sensitive on both antibiotics. The patient was discharged 4 days following the intervention.
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Kulkarni's urethroplasty - good solution for panurethral strictures (video abstract)
(Macedonian Association of Urology, 2019-04)
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Gurmeshevski, Slobodan
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Bekteshi, Vedat
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Shabani, Bashkim
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Optimizing Nephrectomy Outcomes through 3D-Printed Anatomical Replicas
(Macedonian Medical Association, 2024-04)
Arsenkov, Stefan
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Arsenkov, Emilija
The utilization of 3D-printed replicas of patient-specific anatomy represents a significant advancement in the field of surgical planning. This abstract discusses the methodology, benefits, and implications of employing 3D-printed models in the preoperative planning and intraoperative phases of complex surgeries. The process begins with acquiring high-resolution images using CT or MRI. These images are then converted into a digital 3D model, which is used to produce a detailed physical replica of the patient's anatomy using 3D printing. The primary advantage of this approach is the ability to enhance the surgeon's understanding of the tumor's size, location, and relationship with adjacent structures. By physically manipulating the 3D model, surgeons can strategize the most effective surgical approaches, anticipate challenges, and avoid complications. Furthermore, these replicas can be used for patient education, improving their understanding of the procedure and setting realistic expectations. Clinical outcomes have shown the use of 3D-printed models for surgery planning can lead to shorter operation times and reduced intraoperative blood loss. We present the case of a 58-year-old female patient requiring a nephrectomy due to a large tumor of the left kidney. A 3D-printed anatomical replica was used for preoperative planning with promising results. The postoperative histological examination revealed the renal mass was a clear cell carcinoma of the kidney. Additionally, 13 lymph nodes were extracted, none showing signs of metastatic alteration. This not only demonstrates the surgical team's thoroughness but also highlights the added value of the 3D model in enabling meticulous dissection and evaluation of surrounding lymphatic tissue. In conclusion, the integration of 3D-printed anatomical replicas into the surgical workflow for large kidney tumors offers a tangible improvement in preoperative planning, surgical precision, and patient outcomes. As this technology becomes more accessible, it is poised to become a standard tool in the surgical treatment of renal pathologies.
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Bilateral renal pelvis rupture following minor blunt injury
(Srpsko lekarsko društvo, 2023-10)
Tochko, Ognen
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Introduction. Ureteral and renal pelvis injuries due to external trauma are uncommon and account for less than 1% of all urologic traumas. Lesions of the renal pelvis are presented with minimal clinical symptoms. Hematuria and flank pain are the first clinical signs of traumatic injury of the urine collecting system, and excretory urograms and CT scans of the abdomen are reliable diagnostic means. Fever and pain herald urinoma and abscess formation, which if not treated frequently lead to loss of the affected kidney. Case report. A 68-year-old male patient presented at the emergency departement with a history of a fall four days before, after he tripped while walking. He complained about severe pain in the upper abdomen and lumbar region on both sides. The patient also presented with urinary retention. CT scan of the abdomen was performed, detecting rupture of the both renal pelvises. Bilateral ureteral J-J stents were installed. After one month a controlled CT scan was performed where no contrast extravasation was observed suggesting a complete healing of ruptured pelvices. Discussion. Renal pelvis rupture after blunt abdominal trauma is rare clinical entity. Common causes for such an event include congenitally abnormal kidneys, cystic conditions, hydronephrosis, history of renal transplantation and various iatrogenic procedures. In blunt abdominal trauma simultaneous rupture of bladder and pelvicaliceal system may occur if patient has chronically distended bladder in the presence of chronic retention. Rupture is reported to occur when intrapelvic pressures exceed 25 to 75mmHg and is seen most frequently at the fornices, possibly where the walls are the thinnest. Symptomatology is simmilar with renal colic, but sometimes could mimic an acute abdomen. Computed tomography does not confirm only contrast extravasation, but may also show the site of rupture. Smallsized urinomas may be resorbed spontaneously even without drainage. Currently, spontaneous renal pelvis rupture is successfully treated by ureteral stent implantation. If big urinoma is presented there may be need for percutaneus nephrostomy tube to evacuate the collection. Conclusion. Renal pelvis rupture can occur even in minor blunt abdominal traumas. Obtaining a good medical history and correct radiographic exams is mandatory. Ureteral stent installation helps renal pelvis to heal leading to normal function of the urinary system and is method of choice that results with positive outcome for the patient.
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Buccal mucosa urethroplasty - what technique for what stricture?
(Macedonian Association of Urology, 2019-04)
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Gurmeshevski, Slobodan
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Bekteshi, Vedat
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ACQUIRED HEMOPHILIA A REASON FOR ACUTE ABDOMEN - CASE REPORT
(2016-10)
Spasovski, Zharko
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Karpuzi, Arben
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Blazhevski, Bozhidar
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Laparocopic radical prostatectomy without ligation of the Santorini's venous complex
(Macedonian Association of Urology, 2019-04)
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Gurmeshevski, Slobodan
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Bekteshi, Vedat
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Shabani, Bashkim
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Glans penis yet another place where malignant melanoma can appear
(Srpsko lekarsko društvo, 2023-10)
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Tochko, Ognen
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Introduction. Primary melanomas of the glans penis and male urethra are exceptionally rare, constituting less than 0.1% of all malignant melanomas, and 1.4% of all penile cancers. Melanomas arise from malignant transformation of melanocytes. Melanomas situated on the penis may be cutaneous or mucosal. The primary cause of cutaneous melanoma is ultraviolet light exposure, but the sunlight is not a causative factor for mucosal melanomas, and their etiology is unknown. Case report. A 66-year-old uncircumcised men presented with blackish tumorous nodule on glans penis with a size of 13x10 mm on peduncle 2x2 mm. Biopsy with wedge excision was made in favor of malignant melanoma. Chest X-ray and abdominal CT were made and metastasis in the left superficial inguinal lymph nodes with a size of 16x12x11 mm was detected. A partial penectomy with 20 mm resection margins and left inguinal lymphadenectomy was performed. Only one positive node was recorded. No residual tumorous tissue was detected on the penis. Histopathologic classification including the first finding was Breslow’s 4 (5 mm), Clark’s 3, pT4b, pN1b, Stage IIIC. The patient was referred to oncology where he received chemotherapy. There are no signs of recurrence and metastases in other locations two years following the surgery. Discussion: Melanoma on glans penis typically presents as colored lesions, the color varying from black, blue, brown, grey or amelanotic. Median patient age is 65 years. Once the diagnosis is verified, serum LDH levels are determined and CT scan of brain, chest, abdomen, and pelvis or positron emission tomography scans are performed to assess the disease’s stage. For stage I/stage A organ-sparing surgery with local excision, urethrectomy, glans amputation or partial penectomy is sufficient. The benefit of lymphadenectomy remains questionable. However, for patient with groin lymph node metastases an ilioinguinal lymph node dissection should be undertaken. For stage II/stage B glans and urethral melanomas, the prognosis is poor. In patients with lymph node involvement, the reported two-year survival rate is nearly 0%. Instead of radical surgery, tumor excision combined with chemo-immunotherapy can be used with equal results and lesser postoperative morbidity. Radiotherapy has shown no special benefit in glans and urethral melanomas. Mucosal malignant melanomas have worse prognosis than the cutaneous form. Two and five years overall survival in a patient with penis melanoma is 63% and 31%, respectively. Adverse prognostic factors are tumor thickness >3.5 mm, ulceration, and tumor diameter >15 mm. Conclusion. Malignant melanoma can appear on any part of the skin, and even on the glans penis. The appearance of a tumor formation with blackish discoloration should always alert us to the possibility of malignant melanoma. Although these cancers are very rare in the literature they have high mortality. Treatment is surgical and includes conservative procedures for localized disease and radical surgeries for locally advanced cases.
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Laparoskopna radikalna cistektomija sa ekstrakorporalnom derivacijom urina - početno iskustvo i preliminarni rezultati
(Okruzna podružnica SLD Leskovac, 2020)
Shabani, Bashkim
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Gurmeshevski, Slobodan
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SUMMARY Introduction and objectives: To report our experience with laparoscopic radical cystectomy (LRC) and extracorporeal urinary diversion for muscleinvasive bladder cancer. We have evaluated and summarized the surgical outcomes and complications of this procedure. Patients and methods: We have evaluated retrospectively all patients who underwent LRC at our clinic over a one year period. In all patients, ureteroileocutaneostomy (Bricker technique) was performed for urinary derivation. We have analyzed the following parameters: patient demographic data, laboratory data, intraoperative fluid volume, estimated blood loss and transfusion requirements. Respiratory parameters including arterial blood gas data, anesthesia time, surgical time, time of oral intake, admission to ICU (intensive care unit), hospital stay and any adverse events during the whole period of hospitalization were also analyzed. Results: Patients had similar demographic characteristics. Estimated intraoperative blood loss was 392 ml. Due to prolonged surgical time and CO2 pneumoperitoneum, hypercapnia was observed in 3 patients. Patients had a short period of bowel dysfunction and rapid shift from parenteral to oral nutrition, short hospital stay and low rate of surgical compilations. Conclusion: The results of our study have shown that laparoscopic radical cystectomy is a safe, feasible, and effective alternative to open radical cystectomy. Ex tra cor - po real urinary diversion through a small incision decreases the operating time, while maintaining the benefits of laparoscopic surgery. However, some larger prospective evaluation is to be made for summarizing the overall conclusions.

Pejkov, Risto

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