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Biomedical subjects

I Jekić

Publications and source records attributed to I Jekić.

5 recordsLinked to original sources

[Localized plano-cellular type of Castleman's disease].

Castleman was first to study lymphoid tumour of the mediastinum with characteristic histologic features which had until then been mistaken for thymommas grossly, radiologically and histologically. It was soon evidented that the condition occurred in regions other then the mediastinum and even in places where lymph nodes are not normally presents. Localised plasma cell type is rare variant of Castlemans disease, especially as an intraabdominal variant. Most patients present with local symptoms, but general malaise or fever, anaemia, elevated sedimentation rate, polyclonal hypergamaglobulinemia etc. can be present. Using preoperative imaging procedures solid, well-circumscribed expansive mass can be detected. After surgical excision and patohistological examination diagnosis can be established. In this paper we report rare case of localised plasma cell type of Castlemans disease. Other types of disease, diagnostic findings and therapeutic possibilities are discussed.

Abdominal Neoplasms↗

[Complications in esophagojejunal anastomosis].

In the period between January 1, 1982 until December 31 1993, in the Center for Esophageal Surgery, Institute for Digestive Disease - 1 st Surgical clinic in Belgrade, 345 esophago-jejuno anastomosis (EJA) were performed. In 326 pt's EJA, with the Roux-en-Y reconstruction with the segment of the small intestine, was performed after a total gastrectomy due to a malignant disease of stomach or cardia and in 7 due to an extensive corrosive changes of the stomach. In 12 pt's a resection of the distal esophagus due to an undilatable stricture and the reconstruction with the short segment of the small intestine (Merendino) was performed. In all 345 pt's a terminolaternal EJA was performed. In 149 pt's EJA was done mechanically by staplers (e.g., the EEA instrument) and in 196 an interrupted two layer suture was performed. In 326 pt's (operated due to a malignant disease) complications occurred in 29 of them (8.89%) while in the group of patients with benignant disease only in 2 pt's or 10.52%. A dehiscention of EJA occurred only in the group of pt's with malignant disease. Comparing the way of performing EJA a higher percentage of anastomotic leaks was found in the group of hand sewn anastomosis (18/8.16%) while in the group with a stapler performed anastomosis anastomotic leak was found only in 7 pt's (4.69%). In two pt's where a stapler anastomosis was performed there was a hemorrhage from the anastomosis during the operation, and in 8 pt's or 5.36% an unsuccessful anastomosis using a stapler was performed. Overall mortality was 6.66% or 23 pt's. Due to anastomotic leak 13 pt's died (3.76%). In 5 pt's 4 to 14 months after the operation a stenosis of anastomosis developed on EJA that severely compromised EJA and needed further medical treatment. None of the pt's was reoperated.

Anastomosis, Surgical↗

[Advantages and disadvantages of esophagogastroplasty in reconstruction of malignant and benign esophageal stenosis].

Advantageous morphology, sufficient blood supply and good tissue quality predispose use of stomach for ideal substitute in subtotal and total esophagoplasty. Additional advantages are one act surgery and possibility of single anastomosis formation. In an eighteen years' time, since 1976., two hundred nine (209) patients were operated with use of esophagogastroplasty for malignancies and benign diseases of esophagus and hyphopharinx. The esophagogastric anastomosis is most common reconstructive procedure for esophageal and hyphopharingeal malignancies. Anastomosis on pharyngeal level was made in 13 pts., on cervical esophagus level in 168 pts. and on thoracic esophagus level in the rest of 28 pts. Overall postoperative morbidity was 25,36%. Most common complication was anastomotic dehiscence (18,66%), transplant necrosis occurred in 2% of pts., whereas stenosis of the anastomosis was observed in 4,78% of pts. Overall intrahospital mortality was 14,38%, while specific mortality (anastomotic dehiscence and/or transplant necrosis) was 10,04% (21 pts.), whereas nonspecific mortality (predominantly lung insufficiency) was 4,78% (10 pts.). Anastomotic dehiscence is major disadvantage of this method.

Anastomosis, Surgical↗

[Polytrauma with retroperitoneal injuries].

From 1971-1987, 598 polytraumatized patients had concomitant injuries of the retroperitoneal space. The mortality rate came up to 33.4%. Diagnostically abdominal lavage, laparoscopy, selective angiography and CT were carried out. Often life saving laparotomy had to be practised without further delay.

Abdominal Injuries↗