Arben Gjata - Academia.edu (original) (raw)

Papers by Arben Gjata

Albanian Journal of Trauma and Emergency Surgery

Despite the continuing decline in incidence, stomach cancer remains one of the most common and de... more Despite the continuing decline in incidence, stomach cancer remains one of the most common and deadly neoplasms in the world [1]. According to the literature, stomach cancer is the third leading cause of cancer deaths worldwide, ranking third after lung cancer and colorectal in global cancer mortality. About 1 in 12 neoplasm deaths can be attributed to stomach cancer, which has 5 times the highest incidence among all cancers, and over one million new cases of stomach cancer are diagnosed each year worldwide.[2] Our objectives were: Evidence and detailed statistical description of demographic, diagnostic, clinical, pathological data of stomach cancer patients are included in this study were hospitalized in two clinical surgery medical centers in the period from January 2009 to January 2019, in University Clinical Center in Prishtina-Department of Surgery, Regional Hospital in Ferizaj-Department of Surgery. Material and methods; The study included 115 patients who met the criteria, an...

Book Publisher International (a part of SCIENCEDOMAIN International), Nov 25, 2021

PubMed, Apr 1, 2013

Background: Duodenal injuries are rare in children and classically present following a fall over ... more Background: Duodenal injuries are rare in children and classically present following a fall over the handle bar. Retroperitoneal location of the duodenum may lead to delay in diagnosis, and missed injuries are associated with increased morbidity and mortality. Case report: A 5-year-old child was admitted to the National Trauma Center, in Tirana (Albania), 28 hours after a Motor Vehicle Crash (MVC), complaining of mild abdominal pain. He was febrile (39°C) and had a white blood cells count of 18,000 mm³. On physical exam he had mild tenderness. Plain abdominal X-rays and Focused Abdominal Sonography for Trauma (FAST) were negative for free air or free fluid. The CT scan of the abdomen demonstrated free air and fluid in the retroperitoneal space. At laparatomy, a perforation of the second portion of the duodenum was found. A single layer suture repair of the duodenum with wide drainage was performed. The patient was discharged from the hospital tolerating oral feeding 8 days later. Conclusion: Duodenal injuries in children are rare. Most duodenal hematomas are managed non-operatively. This is a case of MCV with delayed presentation that was treated surgically for perforation successfully.

World Journal of Emergency Surgery, Jun 7, 2017

Background: The conservative treatment of liver trauma has made important progress over the last ... more Background: The conservative treatment of liver trauma has made important progress over the last 10 years at the Trauma University Hospital in Tirana, Albania. The percentage of success was 58.7%. The aims of this study were to analyze the conservative treatment of liver trauma and to compare the results with those in the literature. Methods: This study was conducted prospectively from January 2009 to December 2012. We analyzed 173 patients admitted to our hospital with liver trauma. Liver injuries were evaluated according to the American Association for the Surgery of Trauma and the World Society of Emergency Surgery classification, while the anatomic gravity of the associated injuries was defined using the Injury Severity Score system. The potential mortality was estimated with the Revised Trauma Score. Results: Out of the 173 patients with liver trauma, 83.2% were male. The main cause of liver trauma was motor vehicle crashes (50.9%). Blunt trauma was the cause of liver injury in 129 cases (74.6%), and penetrating trauma occurred in 44 cases (25.4%). Initially, the decision was to manage 88 cases (50.9%) via the conservative approach. Of these, 73 cases (42.2%) were successfully treated with conservative treatment, while in 15 cases (17.2%), this approach failed. The success rate of conservative treatment by grade of injuries was as follows: grade I (38.4%), grade II (30.1%), grade III (28.8%), and grade IV (2.7%). The likelihood of the success of conservative treatment had a significant correlation with the grade of the liver injury (p < 0.00001), associated intra-abdominal injuries (p = 0.00051), and complications (z = 2.3169, p = 0.02051). The overall mortality rate of liver trauma was 13.2%. Conclusions: The likelihood of success in using conservative treatment had a significant correlation with the grade of liver injury and associated intra-abdominal injuries. The limited hospital resources and low level of consensus on conservative treatment had a negative impact on the level of success.

International Journal Of Medical Science And Clinical Invention, Aug 1, 2016

Surgical treatment of anal stricture in open posthemorrhoidectomy brings various complications to... more Surgical treatment of anal stricture in open posthemorrhoidectomy brings various complications to the open hemorrhoidectomy in 5%-10% of the cases. In books it is widely known as "the fibrotic benign stricture" or as "iatrogenic stricture". Clinically, it is manifested with pain during defecation, minimal rectoragy and abdominal discomfort accompanied with a feeling of not having adequately emptied the bowels. Locally, it is manifested in the form of a rigid ring where even the small finger can hardly be penetrated. These symptoms can severely affect the quality of life in patients. Depending on the grade of the anal canal stricture, we can say that the anal stricture is found on three grades: light anal stricture, moderated anal stricture and expressed anal stricture. All our patients resulted in expressed anal stricture. In our research we have compared two operative techniques which were applied for the surgical treatment of the pathology. Partial posterior internal sphincterotomy technique with anoplastic in the open wound (SIPA) and the plastic with skin flap and closed internal lateral sphincterotomy, V-Y advancement flap (PLSL). Each technique aims at relaxing the anal canal with as less continence damage as possible and faster rehabilitation of the patient. The patients were divided into two groups: Group A of 15 patients treated with the SIPA technique and Group B of 14 patients treated with the PLSL technique. The study was conducted during February 2006-March 2014. The results favored the PLSL technique. Patients and Method This research summarizes the results of the surgical treatment in 29 patients diagnosed in open posthemorrhoidectomy anal stricture. The study was conducted during February 2006-March 2014. Average age resulted: 47.21 year old (36-64 years old). The patients were called in for a visit after approximately 64.6 days (45-78 days) after the first intervention. The second intervention was conducted within ten days from Submission. It was performed with spinal anesthesia, by injecting 2 ml lidocain solution, 2 % in the intervertebral area L3-L4. Before surgery all patients had the routine tests done, were evaluated about the accompanying pathologies and were performed an anoscopy with pediatric anoscope (Hill-Ferguson) (1.5). Preoperative preparation consisted in light hydric diet for two days before surgery and four microclismas four

Il Giornale di chirurgia, 2014

Seat belt syndrome, a new pattern of injury in developing countries. Case report and review of li... more Seat belt syndrome, a new pattern of injury in developing countries. Case report and review of literature.

Protective ileostomy is used to prevent anastomose leaking in low anterior resection, but its val... more Protective ileostomy is used to prevent anastomose leaking in low anterior resection, but its value is still controversial. This study aims to evaluate the role of protective ileostomy in preventing anastomose leaking and the need of reoperation. This is a retrospective study of 217 cases anterior resection of middle and lower rectum. All the data was collected in the III d Clinic of Surgery at Mother Theresa Hospital, from January 2005 to October 2015. Clinical decision, for the need of protective jejunostomy, included: tumor localization, operatory hemorrhage, lymph node removement, simultaneous resection of other organs and the level of anastomose, previous chemoradiotherapy, etc. Anastomotic leaks were found in 21 patients, or 9.7%. It was found a mortality rate of about 1.8% or 4 patients. Protective ileostomy was realized in 76 patients, of whom 9 had anastomose leak. The other 12 cases of anastomose leak were observed in patients who had not a protective ileostomy. Reoperation for fistula was performed in 10 cases, 8 of them did not had a protective stoma. Anterior resection, as the preferred treatment of low rectum cancer, has a low mortality and acceptable morbidity. As regards the value ileostomy in preventing anastomose leakage, there was no statistically difference between the two groups, but it might minimize the consequences and reduces the need for urgent reoperation.

Journal of acute disease, Nov 1, 2016

To evaluate the preoperative radiotherapy and its role in anastomotic leakage. Methods: A total o... more To evaluate the preoperative radiotherapy and its role in anastomotic leakage. Methods: A total of 327 patients who had an anterior resection (AR) in elective surgery for a rectal carcinoma were selected and operated in our clinic of surgery during the period from 2003 to 2015. Among them, 135 patients had a low anterior resection (LAR) and the other 192 had an AR. This is a retrospective study. Chi-squared test was used to evaluate statistical differences and the P < 0.05 was considered statistically significant. Results: A total of 126 patients had radiotherapy before surgery, and 50 of them had a LAR. In the other 201 patients, surgery was the first treatment modality, and 83 of them had a LAR. We had an overall anastomotic leakage of 7.95% or 26% patients. Anastomotic leakage was found in 14 patients with LAR, 9 of which had radiotherapy before surgery. From the 12 patients with AR who had an anastomotic leakage, 6 of them had radiotherapy before surgery. Conclusions: Radiotherapy may affect anastomotic healing and increase the risk of leakage. This risk is higher in low anterior anastomoses where a protective stoma may be considered. A better evaluation and support for patients with preoperative radiotherapy is needed in order to diminish the concomitant risk factors as much as possible.

Albanian Journal of Trauma and Emergency Surgery

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing heal... more The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care. This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care. By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth. Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care. Conclusion: The ATLS course stands as a testament to the commitm...

Parasitology Research

Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due t... more Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due to Echinococcus (E.) granulosus usually involves livestock and dogs; alveolar echinococcosis (AE) due to E. multilocularis involves rodents and canines such as foxes and dogs. Human hosts are infected accidentally via hand to mouth and/or foodborne/waterborne pathways. Albania is deemed to be endemic for cystic echinococcosis (CE), but there is a scarcity of data to confirm this. A systematic literature search was performed in PubMed, Google Scholar, and in other medical sources. Because of the scarcity of existing information, data confirming CE cases were reviewed from the medical hospital records of Albania’s largest Hospital, the Mother Teresa University Hospital (UHCMT) Tirana, and from a large private laboratory in Tirana (Pegasus laboratory). A total of eight eligible publications on 540 CE patients were found. Three hundred forty seven additional cases hospitalized in UHCMT from 2...

Archives of the Balkan Medical Union, Dec 22, 2022

Le phéochromocytome géant non compliqué : rapport de cas Introduction. Les phéochromocytomes sont... more Le phéochromocytome géant non compliqué : rapport de cas Introduction. Les phéochromocytomes sont des tumeurs rares provenant des cellules chromaffines qui sont principalement situées dans les glandes surrénales. Le phéochromocytome est la cause la plus «typique» d'hypertension secondaire. L'hypertension artérielle soutenue ou paroxystique est le signe le plus fréquent de phéochromocytome, éventuellement associé à la triade classique : céphalées épisodiques, sueur et tachycardie. Présentation du cas. Une patiente de 52 ans s'est présentée avec des nausées, vomissements, une légère gêne dans le flanc abdominal droit, céphalée et une hypertension résistante. Elle souffrait d'hypotension orthostatique inexpliquée. Sa surveillance ambulatoire de la pression artérielle montre une pression artérielle normale dans 65% des mesures et un pic d'hypertension à environ 204/110 mmHg. La tomodensitométrie de la tête était normale et la tomodensitométrie de l'abdomen montrait une masse hétérogène entre le lobe hépatique droit et le rein droit, avec une nécrose centrale, de dimensions 90x94x93mm, probablement

Italian Journal of Public Health, 2003

Obiettivi : stimare la prevalenza delle infezioni ospedaliere (IO) e la frequenza di esposizione ... more Obiettivi : stimare la prevalenza delle infezioni ospedaliere (IO) e la frequenza di esposizione a interventi chirurgici e procedure invasive, quantificare l’utilizzo di antibiotici e identificarne le motivazioni, dimensionare il ricorso ai servizi diagnostici, migliorare l’expertise locale nella diagnosi microbiologica delle infezioni e nella sorveglianza delle IO. Metodi : si tratta di un’indagine di prevalenza puntuale, preceduta da uno studio pilota, che coinvolge quasi tutti i reparti del QSUT; si adottano le definizioni di caso di IO dei Centers for Disease Control and Prevention, USA. Per la rilevazione e prevista una scheda ad hoc e come principali fonti informative si useranno la cartella clinica e il registro operatorio. Per l’input e l’analisi dei dati si utilizzera il software EPI INFO 2002. La partnership italiana assicura la supervisione tecnica; a livello locale si sono identificati una figura di coordinamento/verifica e team di rilevazione, validazione delle IO e per...

BJS Open, 2021

BackgroundThe Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointest... more BackgroundThe Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA).MethodsThe OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up.ResultsThe OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts...

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

BJS Open, 2021

Background The complexity of oesophageal surgery and the significant risk of morbidity necessitat... more Background The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. Methods Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. Results Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases...

Albanian Journal of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is or... more After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have ...

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

The Journal of Thoracic and Cardiovascular Surgery, 2021

British Journal of Surgery, 2021

To support the global restart of elective surgery, data from an international prospective cohort ... more To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

Albanian journal of trauma and emergency surgery, Dec 20, 2021

Albanian Journal ofTrauma and Emergency Surgery is the official publication of Albanian Society f... more Albanian Journal ofTrauma and Emergency Surgery is the official publication of Albanian Society for Trauma and Emergency Surgery-ASTES Structure and format AJTES is an open access, peer-reviewed periodical journal that includes editorials, reviews, original articles, casereports, hort reports, ideas and opinions, book reviews, perspectives, seminars, symposium and minisymposium, ethics and rights, health care policy and management, practice guides. The structure of each edition of the publcation comprises section categories determined by Editor and reflects the views of the Editorial Board. Editorial expertise Guidance from Editorial Board consists of leading authorities from a variety and respective fields of medical science. Peer review accomplished by expert selected for their experience and knowledge of a specific topic.

Albanian Journal of Trauma and Emergency Surgery

Despite the continuing decline in incidence, stomach cancer remains one of the most common and de... more Despite the continuing decline in incidence, stomach cancer remains one of the most common and deadly neoplasms in the world [1]. According to the literature, stomach cancer is the third leading cause of cancer deaths worldwide, ranking third after lung cancer and colorectal in global cancer mortality. About 1 in 12 neoplasm deaths can be attributed to stomach cancer, which has 5 times the highest incidence among all cancers, and over one million new cases of stomach cancer are diagnosed each year worldwide.[2] Our objectives were: Evidence and detailed statistical description of demographic, diagnostic, clinical, pathological data of stomach cancer patients are included in this study were hospitalized in two clinical surgery medical centers in the period from January 2009 to January 2019, in University Clinical Center in Prishtina-Department of Surgery, Regional Hospital in Ferizaj-Department of Surgery. Material and methods; The study included 115 patients who met the criteria, an...

Book Publisher International (a part of SCIENCEDOMAIN International), Nov 25, 2021

PubMed, Apr 1, 2013

Background: Duodenal injuries are rare in children and classically present following a fall over ... more Background: Duodenal injuries are rare in children and classically present following a fall over the handle bar. Retroperitoneal location of the duodenum may lead to delay in diagnosis, and missed injuries are associated with increased morbidity and mortality. Case report: A 5-year-old child was admitted to the National Trauma Center, in Tirana (Albania), 28 hours after a Motor Vehicle Crash (MVC), complaining of mild abdominal pain. He was febrile (39°C) and had a white blood cells count of 18,000 mm³. On physical exam he had mild tenderness. Plain abdominal X-rays and Focused Abdominal Sonography for Trauma (FAST) were negative for free air or free fluid. The CT scan of the abdomen demonstrated free air and fluid in the retroperitoneal space. At laparatomy, a perforation of the second portion of the duodenum was found. A single layer suture repair of the duodenum with wide drainage was performed. The patient was discharged from the hospital tolerating oral feeding 8 days later. Conclusion: Duodenal injuries in children are rare. Most duodenal hematomas are managed non-operatively. This is a case of MCV with delayed presentation that was treated surgically for perforation successfully.

World Journal of Emergency Surgery, Jun 7, 2017

Background: The conservative treatment of liver trauma has made important progress over the last ... more Background: The conservative treatment of liver trauma has made important progress over the last 10 years at the Trauma University Hospital in Tirana, Albania. The percentage of success was 58.7%. The aims of this study were to analyze the conservative treatment of liver trauma and to compare the results with those in the literature. Methods: This study was conducted prospectively from January 2009 to December 2012. We analyzed 173 patients admitted to our hospital with liver trauma. Liver injuries were evaluated according to the American Association for the Surgery of Trauma and the World Society of Emergency Surgery classification, while the anatomic gravity of the associated injuries was defined using the Injury Severity Score system. The potential mortality was estimated with the Revised Trauma Score. Results: Out of the 173 patients with liver trauma, 83.2% were male. The main cause of liver trauma was motor vehicle crashes (50.9%). Blunt trauma was the cause of liver injury in 129 cases (74.6%), and penetrating trauma occurred in 44 cases (25.4%). Initially, the decision was to manage 88 cases (50.9%) via the conservative approach. Of these, 73 cases (42.2%) were successfully treated with conservative treatment, while in 15 cases (17.2%), this approach failed. The success rate of conservative treatment by grade of injuries was as follows: grade I (38.4%), grade II (30.1%), grade III (28.8%), and grade IV (2.7%). The likelihood of the success of conservative treatment had a significant correlation with the grade of the liver injury (p < 0.00001), associated intra-abdominal injuries (p = 0.00051), and complications (z = 2.3169, p = 0.02051). The overall mortality rate of liver trauma was 13.2%. Conclusions: The likelihood of success in using conservative treatment had a significant correlation with the grade of liver injury and associated intra-abdominal injuries. The limited hospital resources and low level of consensus on conservative treatment had a negative impact on the level of success.

International Journal Of Medical Science And Clinical Invention, Aug 1, 2016

Surgical treatment of anal stricture in open posthemorrhoidectomy brings various complications to... more Surgical treatment of anal stricture in open posthemorrhoidectomy brings various complications to the open hemorrhoidectomy in 5%-10% of the cases. In books it is widely known as "the fibrotic benign stricture" or as "iatrogenic stricture". Clinically, it is manifested with pain during defecation, minimal rectoragy and abdominal discomfort accompanied with a feeling of not having adequately emptied the bowels. Locally, it is manifested in the form of a rigid ring where even the small finger can hardly be penetrated. These symptoms can severely affect the quality of life in patients. Depending on the grade of the anal canal stricture, we can say that the anal stricture is found on three grades: light anal stricture, moderated anal stricture and expressed anal stricture. All our patients resulted in expressed anal stricture. In our research we have compared two operative techniques which were applied for the surgical treatment of the pathology. Partial posterior internal sphincterotomy technique with anoplastic in the open wound (SIPA) and the plastic with skin flap and closed internal lateral sphincterotomy, V-Y advancement flap (PLSL). Each technique aims at relaxing the anal canal with as less continence damage as possible and faster rehabilitation of the patient. The patients were divided into two groups: Group A of 15 patients treated with the SIPA technique and Group B of 14 patients treated with the PLSL technique. The study was conducted during February 2006-March 2014. The results favored the PLSL technique. Patients and Method This research summarizes the results of the surgical treatment in 29 patients diagnosed in open posthemorrhoidectomy anal stricture. The study was conducted during February 2006-March 2014. Average age resulted: 47.21 year old (36-64 years old). The patients were called in for a visit after approximately 64.6 days (45-78 days) after the first intervention. The second intervention was conducted within ten days from Submission. It was performed with spinal anesthesia, by injecting 2 ml lidocain solution, 2 % in the intervertebral area L3-L4. Before surgery all patients had the routine tests done, were evaluated about the accompanying pathologies and were performed an anoscopy with pediatric anoscope (Hill-Ferguson) (1.5). Preoperative preparation consisted in light hydric diet for two days before surgery and four microclismas four

Il Giornale di chirurgia, 2014

Seat belt syndrome, a new pattern of injury in developing countries. Case report and review of li... more Seat belt syndrome, a new pattern of injury in developing countries. Case report and review of literature.

Protective ileostomy is used to prevent anastomose leaking in low anterior resection, but its val... more Protective ileostomy is used to prevent anastomose leaking in low anterior resection, but its value is still controversial. This study aims to evaluate the role of protective ileostomy in preventing anastomose leaking and the need of reoperation. This is a retrospective study of 217 cases anterior resection of middle and lower rectum. All the data was collected in the III d Clinic of Surgery at Mother Theresa Hospital, from January 2005 to October 2015. Clinical decision, for the need of protective jejunostomy, included: tumor localization, operatory hemorrhage, lymph node removement, simultaneous resection of other organs and the level of anastomose, previous chemoradiotherapy, etc. Anastomotic leaks were found in 21 patients, or 9.7%. It was found a mortality rate of about 1.8% or 4 patients. Protective ileostomy was realized in 76 patients, of whom 9 had anastomose leak. The other 12 cases of anastomose leak were observed in patients who had not a protective ileostomy. Reoperation for fistula was performed in 10 cases, 8 of them did not had a protective stoma. Anterior resection, as the preferred treatment of low rectum cancer, has a low mortality and acceptable morbidity. As regards the value ileostomy in preventing anastomose leakage, there was no statistically difference between the two groups, but it might minimize the consequences and reduces the need for urgent reoperation.

Journal of acute disease, Nov 1, 2016

To evaluate the preoperative radiotherapy and its role in anastomotic leakage. Methods: A total o... more To evaluate the preoperative radiotherapy and its role in anastomotic leakage. Methods: A total of 327 patients who had an anterior resection (AR) in elective surgery for a rectal carcinoma were selected and operated in our clinic of surgery during the period from 2003 to 2015. Among them, 135 patients had a low anterior resection (LAR) and the other 192 had an AR. This is a retrospective study. Chi-squared test was used to evaluate statistical differences and the P < 0.05 was considered statistically significant. Results: A total of 126 patients had radiotherapy before surgery, and 50 of them had a LAR. In the other 201 patients, surgery was the first treatment modality, and 83 of them had a LAR. We had an overall anastomotic leakage of 7.95% or 26% patients. Anastomotic leakage was found in 14 patients with LAR, 9 of which had radiotherapy before surgery. From the 12 patients with AR who had an anastomotic leakage, 6 of them had radiotherapy before surgery. Conclusions: Radiotherapy may affect anastomotic healing and increase the risk of leakage. This risk is higher in low anterior anastomoses where a protective stoma may be considered. A better evaluation and support for patients with preoperative radiotherapy is needed in order to diminish the concomitant risk factors as much as possible.

Albanian Journal of Trauma and Emergency Surgery

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing heal... more The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care. This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care. By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth. Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care. Conclusion: The ATLS course stands as a testament to the commitm...

Parasitology Research

Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due t... more Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due to Echinococcus (E.) granulosus usually involves livestock and dogs; alveolar echinococcosis (AE) due to E. multilocularis involves rodents and canines such as foxes and dogs. Human hosts are infected accidentally via hand to mouth and/or foodborne/waterborne pathways. Albania is deemed to be endemic for cystic echinococcosis (CE), but there is a scarcity of data to confirm this. A systematic literature search was performed in PubMed, Google Scholar, and in other medical sources. Because of the scarcity of existing information, data confirming CE cases were reviewed from the medical hospital records of Albania’s largest Hospital, the Mother Teresa University Hospital (UHCMT) Tirana, and from a large private laboratory in Tirana (Pegasus laboratory). A total of eight eligible publications on 540 CE patients were found. Three hundred forty seven additional cases hospitalized in UHCMT from 2...

Archives of the Balkan Medical Union, Dec 22, 2022

Le phéochromocytome géant non compliqué : rapport de cas Introduction. Les phéochromocytomes sont... more Le phéochromocytome géant non compliqué : rapport de cas Introduction. Les phéochromocytomes sont des tumeurs rares provenant des cellules chromaffines qui sont principalement situées dans les glandes surrénales. Le phéochromocytome est la cause la plus «typique» d'hypertension secondaire. L'hypertension artérielle soutenue ou paroxystique est le signe le plus fréquent de phéochromocytome, éventuellement associé à la triade classique : céphalées épisodiques, sueur et tachycardie. Présentation du cas. Une patiente de 52 ans s'est présentée avec des nausées, vomissements, une légère gêne dans le flanc abdominal droit, céphalée et une hypertension résistante. Elle souffrait d'hypotension orthostatique inexpliquée. Sa surveillance ambulatoire de la pression artérielle montre une pression artérielle normale dans 65% des mesures et un pic d'hypertension à environ 204/110 mmHg. La tomodensitométrie de la tête était normale et la tomodensitométrie de l'abdomen montrait une masse hétérogène entre le lobe hépatique droit et le rein droit, avec une nécrose centrale, de dimensions 90x94x93mm, probablement

Italian Journal of Public Health, 2003

Obiettivi : stimare la prevalenza delle infezioni ospedaliere (IO) e la frequenza di esposizione ... more Obiettivi : stimare la prevalenza delle infezioni ospedaliere (IO) e la frequenza di esposizione a interventi chirurgici e procedure invasive, quantificare l’utilizzo di antibiotici e identificarne le motivazioni, dimensionare il ricorso ai servizi diagnostici, migliorare l’expertise locale nella diagnosi microbiologica delle infezioni e nella sorveglianza delle IO. Metodi : si tratta di un’indagine di prevalenza puntuale, preceduta da uno studio pilota, che coinvolge quasi tutti i reparti del QSUT; si adottano le definizioni di caso di IO dei Centers for Disease Control and Prevention, USA. Per la rilevazione e prevista una scheda ad hoc e come principali fonti informative si useranno la cartella clinica e il registro operatorio. Per l’input e l’analisi dei dati si utilizzera il software EPI INFO 2002. La partnership italiana assicura la supervisione tecnica; a livello locale si sono identificati una figura di coordinamento/verifica e team di rilevazione, validazione delle IO e per...

BJS Open, 2021

BackgroundThe Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointest... more BackgroundThe Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA).MethodsThe OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up.ResultsThe OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts...

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

BJS Open, 2021

Background The complexity of oesophageal surgery and the significant risk of morbidity necessitat... more Background The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. Methods Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. Results Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases...

Albanian Journal of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is or... more After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have ...

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

The Journal of Thoracic and Cardiovascular Surgery, 2021

British Journal of Surgery, 2021

To support the global restart of elective surgery, data from an international prospective cohort ... more To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

Albanian journal of trauma and emergency surgery, Dec 20, 2021

Albanian Journal ofTrauma and Emergency Surgery is the official publication of Albanian Society f... more Albanian Journal ofTrauma and Emergency Surgery is the official publication of Albanian Society for Trauma and Emergency Surgery-ASTES Structure and format AJTES is an open access, peer-reviewed periodical journal that includes editorials, reviews, original articles, casereports, hort reports, ideas and opinions, book reviews, perspectives, seminars, symposium and minisymposium, ethics and rights, health care policy and management, practice guides. The structure of each edition of the publcation comprises section categories determined by Editor and reflects the views of the Editorial Board. Editorial expertise Guidance from Editorial Board consists of leading authorities from a variety and respective fields of medical science. Peer review accomplished by expert selected for their experience and knowledge of a specific topic.