Zoran Kostic - Academia.edu (original) (raw)
Papers by Zoran Kostic
Vojnosanitetski pregled
Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increase... more Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increases morbidity and mortality, prolongs hospitalization and increases total treatment costs. In the present study, we aimed to determine incidence, in-hospital mortality and risk factors (RFs) of HAP in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade (Serbia). Methods. Through regular hospital surveillance of patients who underwent intra-abdominal surgical procedures, we prospectively identified postoperative HAP during five years. In the matched case-control study, every surgical patient with HAP was compared with four control patients without HAP. In the group of patients with HAP, those who died were compared with those who survived. Results. Overall 1.4% of all intra-abdominal surgical patients developed HAP in the postoperative period. The incidence of HAP (per 1,000 operative procedures) was greatest in patients undergoing exploratory l...
Vojnosanitetski pregled
Background/Aim. Diagnosis of acute appendicitis (AA) remains the most common dilemma of pediatric... more Background/Aim. Diagnosis of acute appendicitis (AA) remains the most common dilemma of pediatric surgical team. Our aim was to determine whether the neutrophil myeloperoxidase index (MPXI), in combination with other laboratory and clinical parameters, can be useful in diagnosis and follow-up of AA in children. Methods. A prospective investigation of MPXI values in 117 consecutive patients, planned for the surgical intervention due to AA, was performed. The patients were stratified into three groups according to the intraoperative finding: the normal/early, uncomplicated and complicated AA. Laboratory analyses were done preoperativly, on the 1st and on the 3rd postoperative days. Results. The statistically significant difference of MPXI values between the uncomplicated and complicated appendicitis before surgery and the positive correlations between the MPXI and C-reactive protein, as well as interleukin- 6, before surgery were found. Postoperatively, in the group of uncomplicated, ...
Antimicrobial resistance and infection control, 2017
The objective of this study was to investigate independent risk factors (RFs) connected with heal... more The objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital. Risk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI. The overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93-58.4), the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41-6.40), and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18-4.39). Patients with HA CDI had significantly higher in-hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84-43.43). CDI is an important HA infection in population of surgical patients and this study emph...
Vojnosanitetski pregled, 2016
Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the mo... more Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the most frequent abdominal operation in the pediatric surgery. Diagnosis of AA in children is more difficult due to a lack of cooperation and poor clinical history data, leading to significant number of misdiagnostic cases. Our aim was to explore whether neutrophil to lymphocyte ratio (NLR) may be useful in diagnosis and follow-up of AA in children. Methods. Prospective investigation of NLR values in 129 consecutive patients admitted to the Mother and Child Healthcare Institute of Serbia and referred for surgery due to AA was performed. According to the pathohistological findings, patients were divided into 3 groups: normal/early, uncomplicated (phlegmonous) and complicated (gangrenous or/and perforated) AA. Laboratory analysis was done preoperativly and on the 1st and the 3rd postoperative days. Results. Statistically significant differences of NLR values were found in the different time poi...
Vojnosanitetski pregled, 2016
Introduction. Castleman disease is a rare disease of the unknown etiology, occuring in two clinic... more Introduction. Castleman disease is a rare disease of the unknown etiology, occuring in two clinical forms: unicentric or multicentric. It is characterized by the hyperplasia of lymph glands. In literature the four pathohistological forms were described: hyaline vascular type, plasma cell type, mixed type and a recently recognized plasmablastic type. The most frequent changes are localized in the mediastinum, while the abdominal localization is with significatly rare occurrence, and that was the motive for presentation of this case. Case report. In a 41-year old male magnetic resonance (MR) enterography showed a change in the ileocecal area without the presence of subjective symptoms of digestive tract and without loss of body mass. Due to the suspicion of stromal tumor, surgical intervention was indicated. Pathohistological findings showed Castleman lymphadenopathia reactiva mesenterii (plasma cell type) which was in the unicentric form. There were present only anaemia and the incre...
Vojnosanitetski pregled, 2015
Background/Aim. Postoperative infectious complications are one of the most important problems in ... more Background/Aim. Postoperative infectious complications are one of the most important problems in surgical treatment of colorectal cancer (CRC), being present in up to 40% of patients. The aim of this paper was to establish the significance of serial measurement of C-reactive protein (CRP) in serum and matrix metalloproteinase-9 (MMP-9) in drainage fluid for the detection of infectious complications and anastomotic leakage (AL) in patients with colorectal resection. Methods. CRP and MMP-9 values in serum and drainage fluid, respectively, were measured on the first, third, fifth, and seventh postoperative day (POD) in 150 patients with colorectal resection and primary anastomosis. The values obtained were compared between the patients without complications and those with surgical site and remote infections and AL. Results. Surgical site infections (SSIs) were observed in 41 (27.3%), and remote infections in 10 (6.7%) patients. Clinically evident AL was observed in 15 (10%) patients. I...
Acta chirurgica Iugoslavica, 2003
Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneo... more Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneous surgical institutions with different surgical approach, operative technique and radicality have published reports with great discrepancy in incidence of complications, analyzing them with different methods of diagnosis and result evaluation. In the same way it is well known that higher latitude of operative procedure gave better control of thyroid diseases, but it can be accompanied with more complications. All of that motivate us to analyze complications of operative treatment in our patients under well known criteria, with hypothesis that higher radicality of operative procedure do not increase incidence of complications, and that this incidence is in correlations with results published in world literature. Aim of this nonrandomized study was to analyze results of operative treatment for huge number of consecutively operated patients in our teaching hospital, to analyze and compare ...
Acta chirurgica Iugoslavica, 2001
Vojnosanitetski pregled, 2006
Vojnosanitetski pregled, 2006
Background/Aim. Surgical treatment of patients with gastric adenocarcinoma means the total excisi... more Background/Aim. Surgical treatment of patients with gastric adenocarcinoma means the total excision of a tumor and the pathways of its spreading with the risk of operational complications as low as possible. The aim of this study was to evaluate the type and frequency of early postoperative complications and mortality after a radical surgical treatment of patients with gastric adenocarcinoma. Methods. Complication rates and postoperative mortality were studied in 70 consecutive patients in whom a radical surgical procedure, gastrectomy (total or subtotal) with D2 lymphadenectomy, was performed. In the early postoperative period, the frequencies of general and specific complications were detected. The frequencies of complications were compared between the groups of patients according to the defined clinical, operative and pathohistological paramethers. Results. The overall morbidity and mortality rates were 27.14% and 5.71%, respectively Pancreatic fistula in five, and pleural effusi...
Surgery Today, 2011
A new method for ensuring hemostasis during thyroid surgery has recently been introduced. This te... more A new method for ensuring hemostasis during thyroid surgery has recently been introduced. This technique, electrothermal (LigaSure) and ultrasound blood vessel sealing, is still experimental. The aim of the present study was to evaluate the applications and efficacy of LigaSure by analyzing the duration of the surgery and the rate of complications of the surgical procedure. A total of 23 patients who underwent the LigaSure operation (n(LS) group) were analyzed in a prospective nonrandomized/partly randomized clinical study, and were compared with patients who underwent treatment using the conventional (ligature) surgical technique. At our institutions, 187 patients were treated surgically for thyroid disease in 2006, and 23 of these patients were treated using LigaSure. The complication rate in the patients treated with LigaSure (n(LS): 4.3%) was lower than those who received conventional ligature surgery. However, given the small number of patients, this difference was not statistically significant (retrospective group n(1): 10.7%; nonrandomized group n(2): 9.8%; and randomized group n(3): 9.1%). The length of surgery in the LigaSure group (n(LS) = 65 ± 3 min) was significantly shorter (P < 0.001) compared with both nonrandomized (n(2) = 71 ± 6 min) and randomized (n(3) = 70 ± 4 min) patients who received a conventional ligature. The application of LigaSure using meticulous surgical technique provides a new option for a safe thyroidectomy. Moreover, the duration of the LigaSure procedure is significantly shorter, and there are fewer complications as compared with the classic surgical thyroidectomy technique.
Acta chirurgica iugoslavica, 2002
Goiters are classified into: the cervical, retrosternal, substernal and intrathoracic. The aim of... more Goiters are classified into: the cervical, retrosternal, substernal and intrathoracic. The aim of research is to analysis of intrathoracic goiters (ITG) which include goiters with more than 80% of tissue in the thoracic cavity and intrathoracic thyroid choristomas. Methods: In prospective non-randomized study were analyzed 21 consecutive patients operated on for intrathoracic non-toxic benign goiters from 1987-98. Fourteen patients with intrathoracic goiters (more than 80% of tissue in the thoracic cavity) and seven patients with intratoracic choristomas were operated. Two groups of ITG were observed according to the expressed symptomatology and surgical approach and complications of operative treatment were compared to the complications of operative treatment of 986 non-ITG non-toxic benign goiters. Results: ITG represented 1,1% of the whole number of operatively treated thyroid diseases. One third of patients were asymptomatic. Commonly observed symptoms were dispnea, stridor and ...
Acta chirurgica iugoslavica, 2003
Background/Aims. Thyroid gland surgery today is not saddled with high incidence of main complicat... more Background/Aims. Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneous surgical institutions with different surgical approach, operative technique and radicality have published reports with great discrepancy in incidence of complications, analyzing them with different methods of diagnosis and result evaluation. In the same way it is well known that higher latitude of operative procedure gave better control of thyroid diseases, but it can be accompanied with more complications. All of that motivate us to analyze complications of operative treatment in our patients under well known criteria, with hypothesis that higher radicality of operative procedure do not increase incidence of complications, and that this incidence is in correlations with results published in world literature. Aim of this nonrandomized study was to analyze results of operative treatment for huge number of consecutively operated patients in our teaching hospital, to ana...
Acta chirurgica iugoslavica, 2003
Intrathoracic goiter (more than 80% of tissue in the thoracic cavity) represents very rare clinic... more Intrathoracic goiter (more than 80% of tissue in the thoracic cavity) represents very rare clinical entity (less than 1% of total number of thyroid gland surgical procedures). Cancer incidence in these goiter is 0-5%. The aim of this article is to present a case report of intrathoracic thyroid papillary carcinoma with multiple compressive syndrome and review of compressive intrathoracic syndrome of thyroid etiology. In our patient we have found: tracheal and oesophageal deviation and compression, superior vena cava syndrome, downhill varices, chylothorax, pericardial effusion, compress of the left a. subclavia, unilateral lesion of recurrent and phrenic nerve, and brachial plexopathy. This was a unique case with multiple compressive syndrome between 3000 patients surgically treated for all kinds of thyroid deceases. Intrathoracic goiter can cause all the known symptoms and syndromes of intrathoracic compression with possibility of rapid deterioration and fatal end.
Vojnosanitetski pregled, 2015
Background/Aim. C-reactive protein (CRP) is considered to be an indicator of postoperative compli... more Background/Aim. C-reactive protein (CRP) is considered to be an indicator of postoperative complications in abdominal surgery. The aim of this study was to determine the significance of serial measurement of CRP in drainage fluid in the detection of anastomotic leakage (AL) in patients with colorectal resection. Methods. CRP values in serum and drainage fluid, respectively, were measured on the first, third, fifth, and seventh postoperative day (POD) in 150 patients with colorectal resection and primary anastomosis. The values obtained were compared between the groups of patient without complications of surgical treatment and those with AL. Results. Clinically evident AL was observed in 15 patients-in two (4.2%) patients with left colonic surgery, and 13 (12.6%) patients with colorectal anastomosis. Mean values of CRP were higher in the patients with AL than in the patients without complications, both in serum and drainage fluid, with the most significant differences recorded on the PODs 5 and 7 (p < 0.001). Correlation analysis showed a positive correlation between serum and drainage fluid CRP levels in both groups of patients. Serum and drainage fluid CRP values on the PODs 5 and 7 are most important in the detection of AL. In 80% of patients with CRP values in the drainage fluid of 53 mg/L for the POD 5 and 42 mg/L for the POD 7 AL was observed. The method specificity was 77% for the POD 5, and 83% for the POD 7. All the patients with CRP values in drainage fluid above 108 mg/L on the POD 5 and 93 mg/L on the POD 7 had AL. Conclusion. Serial measurement of CRP in drainage fluid can reliably be used in the detection of AL in patients with colorectal resection. The most significant values obtained on the PODs 5 and 7 were positively correlated with the values registered in serum.
Acta chirurgica iugoslavica
The evolution of the surgical treatment of Crohn's disease has three attainable aims: to be m... more The evolution of the surgical treatment of Crohn's disease has three attainable aims: to be minimal, safe and therefore timely. Conservative surgery is increasingly the trend in surgical treatment of small-bowel Crohn's disease. Patients with Crohn's disease are managed non-surgically until complications of the disease or failure to thrive or significant side effects of medication occur, and then--at this point--surgery usually occurs. Once a complication has developed, it is not recommended to wait for this to become further complicated. Resectional surgery and strictureplasty for Crohn's disease of the small bowel are today methods of choice. Laparoscopic intestinal surgery is going to be of a great significance. Abdominal surgery for Crohn's disease is not curative and forms only part of a lifetime management of the patient.
Vojnosanitetski pregled
Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increase... more Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increases morbidity and mortality, prolongs hospitalization and increases total treatment costs. In the present study, we aimed to determine incidence, in-hospital mortality and risk factors (RFs) of HAP in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade (Serbia). Methods. Through regular hospital surveillance of patients who underwent intra-abdominal surgical procedures, we prospectively identified postoperative HAP during five years. In the matched case-control study, every surgical patient with HAP was compared with four control patients without HAP. In the group of patients with HAP, those who died were compared with those who survived. Results. Overall 1.4% of all intra-abdominal surgical patients developed HAP in the postoperative period. The incidence of HAP (per 1,000 operative procedures) was greatest in patients undergoing exploratory l...
Vojnosanitetski pregled
Background/Aim. Diagnosis of acute appendicitis (AA) remains the most common dilemma of pediatric... more Background/Aim. Diagnosis of acute appendicitis (AA) remains the most common dilemma of pediatric surgical team. Our aim was to determine whether the neutrophil myeloperoxidase index (MPXI), in combination with other laboratory and clinical parameters, can be useful in diagnosis and follow-up of AA in children. Methods. A prospective investigation of MPXI values in 117 consecutive patients, planned for the surgical intervention due to AA, was performed. The patients were stratified into three groups according to the intraoperative finding: the normal/early, uncomplicated and complicated AA. Laboratory analyses were done preoperativly, on the 1st and on the 3rd postoperative days. Results. The statistically significant difference of MPXI values between the uncomplicated and complicated appendicitis before surgery and the positive correlations between the MPXI and C-reactive protein, as well as interleukin- 6, before surgery were found. Postoperatively, in the group of uncomplicated, ...
Antimicrobial resistance and infection control, 2017
The objective of this study was to investigate independent risk factors (RFs) connected with heal... more The objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital. Risk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI. The overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93-58.4), the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41-6.40), and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18-4.39). Patients with HA CDI had significantly higher in-hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84-43.43). CDI is an important HA infection in population of surgical patients and this study emph...
Vojnosanitetski pregled, 2016
Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the mo... more Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the most frequent abdominal operation in the pediatric surgery. Diagnosis of AA in children is more difficult due to a lack of cooperation and poor clinical history data, leading to significant number of misdiagnostic cases. Our aim was to explore whether neutrophil to lymphocyte ratio (NLR) may be useful in diagnosis and follow-up of AA in children. Methods. Prospective investigation of NLR values in 129 consecutive patients admitted to the Mother and Child Healthcare Institute of Serbia and referred for surgery due to AA was performed. According to the pathohistological findings, patients were divided into 3 groups: normal/early, uncomplicated (phlegmonous) and complicated (gangrenous or/and perforated) AA. Laboratory analysis was done preoperativly and on the 1st and the 3rd postoperative days. Results. Statistically significant differences of NLR values were found in the different time poi...
Vojnosanitetski pregled, 2016
Introduction. Castleman disease is a rare disease of the unknown etiology, occuring in two clinic... more Introduction. Castleman disease is a rare disease of the unknown etiology, occuring in two clinical forms: unicentric or multicentric. It is characterized by the hyperplasia of lymph glands. In literature the four pathohistological forms were described: hyaline vascular type, plasma cell type, mixed type and a recently recognized plasmablastic type. The most frequent changes are localized in the mediastinum, while the abdominal localization is with significatly rare occurrence, and that was the motive for presentation of this case. Case report. In a 41-year old male magnetic resonance (MR) enterography showed a change in the ileocecal area without the presence of subjective symptoms of digestive tract and without loss of body mass. Due to the suspicion of stromal tumor, surgical intervention was indicated. Pathohistological findings showed Castleman lymphadenopathia reactiva mesenterii (plasma cell type) which was in the unicentric form. There were present only anaemia and the incre...
Vojnosanitetski pregled, 2015
Background/Aim. Postoperative infectious complications are one of the most important problems in ... more Background/Aim. Postoperative infectious complications are one of the most important problems in surgical treatment of colorectal cancer (CRC), being present in up to 40% of patients. The aim of this paper was to establish the significance of serial measurement of C-reactive protein (CRP) in serum and matrix metalloproteinase-9 (MMP-9) in drainage fluid for the detection of infectious complications and anastomotic leakage (AL) in patients with colorectal resection. Methods. CRP and MMP-9 values in serum and drainage fluid, respectively, were measured on the first, third, fifth, and seventh postoperative day (POD) in 150 patients with colorectal resection and primary anastomosis. The values obtained were compared between the patients without complications and those with surgical site and remote infections and AL. Results. Surgical site infections (SSIs) were observed in 41 (27.3%), and remote infections in 10 (6.7%) patients. Clinically evident AL was observed in 15 (10%) patients. I...
Acta chirurgica Iugoslavica, 2003
Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneo... more Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneous surgical institutions with different surgical approach, operative technique and radicality have published reports with great discrepancy in incidence of complications, analyzing them with different methods of diagnosis and result evaluation. In the same way it is well known that higher latitude of operative procedure gave better control of thyroid diseases, but it can be accompanied with more complications. All of that motivate us to analyze complications of operative treatment in our patients under well known criteria, with hypothesis that higher radicality of operative procedure do not increase incidence of complications, and that this incidence is in correlations with results published in world literature. Aim of this nonrandomized study was to analyze results of operative treatment for huge number of consecutively operated patients in our teaching hospital, to analyze and compare ...
Acta chirurgica Iugoslavica, 2001
Vojnosanitetski pregled, 2006
Vojnosanitetski pregled, 2006
Background/Aim. Surgical treatment of patients with gastric adenocarcinoma means the total excisi... more Background/Aim. Surgical treatment of patients with gastric adenocarcinoma means the total excision of a tumor and the pathways of its spreading with the risk of operational complications as low as possible. The aim of this study was to evaluate the type and frequency of early postoperative complications and mortality after a radical surgical treatment of patients with gastric adenocarcinoma. Methods. Complication rates and postoperative mortality were studied in 70 consecutive patients in whom a radical surgical procedure, gastrectomy (total or subtotal) with D2 lymphadenectomy, was performed. In the early postoperative period, the frequencies of general and specific complications were detected. The frequencies of complications were compared between the groups of patients according to the defined clinical, operative and pathohistological paramethers. Results. The overall morbidity and mortality rates were 27.14% and 5.71%, respectively Pancreatic fistula in five, and pleural effusi...
Surgery Today, 2011
A new method for ensuring hemostasis during thyroid surgery has recently been introduced. This te... more A new method for ensuring hemostasis during thyroid surgery has recently been introduced. This technique, electrothermal (LigaSure) and ultrasound blood vessel sealing, is still experimental. The aim of the present study was to evaluate the applications and efficacy of LigaSure by analyzing the duration of the surgery and the rate of complications of the surgical procedure. A total of 23 patients who underwent the LigaSure operation (n(LS) group) were analyzed in a prospective nonrandomized/partly randomized clinical study, and were compared with patients who underwent treatment using the conventional (ligature) surgical technique. At our institutions, 187 patients were treated surgically for thyroid disease in 2006, and 23 of these patients were treated using LigaSure. The complication rate in the patients treated with LigaSure (n(LS): 4.3%) was lower than those who received conventional ligature surgery. However, given the small number of patients, this difference was not statistically significant (retrospective group n(1): 10.7%; nonrandomized group n(2): 9.8%; and randomized group n(3): 9.1%). The length of surgery in the LigaSure group (n(LS) = 65 ± 3 min) was significantly shorter (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) compared with both nonrandomized (n(2) = 71 ± 6 min) and randomized (n(3) = 70 ± 4 min) patients who received a conventional ligature. The application of LigaSure using meticulous surgical technique provides a new option for a safe thyroidectomy. Moreover, the duration of the LigaSure procedure is significantly shorter, and there are fewer complications as compared with the classic surgical thyroidectomy technique.
Acta chirurgica iugoslavica, 2002
Goiters are classified into: the cervical, retrosternal, substernal and intrathoracic. The aim of... more Goiters are classified into: the cervical, retrosternal, substernal and intrathoracic. The aim of research is to analysis of intrathoracic goiters (ITG) which include goiters with more than 80% of tissue in the thoracic cavity and intrathoracic thyroid choristomas. Methods: In prospective non-randomized study were analyzed 21 consecutive patients operated on for intrathoracic non-toxic benign goiters from 1987-98. Fourteen patients with intrathoracic goiters (more than 80% of tissue in the thoracic cavity) and seven patients with intratoracic choristomas were operated. Two groups of ITG were observed according to the expressed symptomatology and surgical approach and complications of operative treatment were compared to the complications of operative treatment of 986 non-ITG non-toxic benign goiters. Results: ITG represented 1,1% of the whole number of operatively treated thyroid diseases. One third of patients were asymptomatic. Commonly observed symptoms were dispnea, stridor and ...
Acta chirurgica iugoslavica, 2003
Background/Aims. Thyroid gland surgery today is not saddled with high incidence of main complicat... more Background/Aims. Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneous surgical institutions with different surgical approach, operative technique and radicality have published reports with great discrepancy in incidence of complications, analyzing them with different methods of diagnosis and result evaluation. In the same way it is well known that higher latitude of operative procedure gave better control of thyroid diseases, but it can be accompanied with more complications. All of that motivate us to analyze complications of operative treatment in our patients under well known criteria, with hypothesis that higher radicality of operative procedure do not increase incidence of complications, and that this incidence is in correlations with results published in world literature. Aim of this nonrandomized study was to analyze results of operative treatment for huge number of consecutively operated patients in our teaching hospital, to ana...
Acta chirurgica iugoslavica, 2003
Intrathoracic goiter (more than 80% of tissue in the thoracic cavity) represents very rare clinic... more Intrathoracic goiter (more than 80% of tissue in the thoracic cavity) represents very rare clinical entity (less than 1% of total number of thyroid gland surgical procedures). Cancer incidence in these goiter is 0-5%. The aim of this article is to present a case report of intrathoracic thyroid papillary carcinoma with multiple compressive syndrome and review of compressive intrathoracic syndrome of thyroid etiology. In our patient we have found: tracheal and oesophageal deviation and compression, superior vena cava syndrome, downhill varices, chylothorax, pericardial effusion, compress of the left a. subclavia, unilateral lesion of recurrent and phrenic nerve, and brachial plexopathy. This was a unique case with multiple compressive syndrome between 3000 patients surgically treated for all kinds of thyroid deceases. Intrathoracic goiter can cause all the known symptoms and syndromes of intrathoracic compression with possibility of rapid deterioration and fatal end.
Vojnosanitetski pregled, 2015
Background/Aim. C-reactive protein (CRP) is considered to be an indicator of postoperative compli... more Background/Aim. C-reactive protein (CRP) is considered to be an indicator of postoperative complications in abdominal surgery. The aim of this study was to determine the significance of serial measurement of CRP in drainage fluid in the detection of anastomotic leakage (AL) in patients with colorectal resection. Methods. CRP values in serum and drainage fluid, respectively, were measured on the first, third, fifth, and seventh postoperative day (POD) in 150 patients with colorectal resection and primary anastomosis. The values obtained were compared between the groups of patient without complications of surgical treatment and those with AL. Results. Clinically evident AL was observed in 15 patients-in two (4.2%) patients with left colonic surgery, and 13 (12.6%) patients with colorectal anastomosis. Mean values of CRP were higher in the patients with AL than in the patients without complications, both in serum and drainage fluid, with the most significant differences recorded on the PODs 5 and 7 (p < 0.001). Correlation analysis showed a positive correlation between serum and drainage fluid CRP levels in both groups of patients. Serum and drainage fluid CRP values on the PODs 5 and 7 are most important in the detection of AL. In 80% of patients with CRP values in the drainage fluid of 53 mg/L for the POD 5 and 42 mg/L for the POD 7 AL was observed. The method specificity was 77% for the POD 5, and 83% for the POD 7. All the patients with CRP values in drainage fluid above 108 mg/L on the POD 5 and 93 mg/L on the POD 7 had AL. Conclusion. Serial measurement of CRP in drainage fluid can reliably be used in the detection of AL in patients with colorectal resection. The most significant values obtained on the PODs 5 and 7 were positively correlated with the values registered in serum.
Acta chirurgica iugoslavica
The evolution of the surgical treatment of Crohn's disease has three attainable aims: to be m... more The evolution of the surgical treatment of Crohn's disease has three attainable aims: to be minimal, safe and therefore timely. Conservative surgery is increasingly the trend in surgical treatment of small-bowel Crohn's disease. Patients with Crohn's disease are managed non-surgically until complications of the disease or failure to thrive or significant side effects of medication occur, and then--at this point--surgery usually occurs. Once a complication has developed, it is not recommended to wait for this to become further complicated. Resectional surgery and strictureplasty for Crohn's disease of the small bowel are today methods of choice. Laparoscopic intestinal surgery is going to be of a great significance. Abdominal surgery for Crohn's disease is not curative and forms only part of a lifetime management of the patient.