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Biomedical subjects

V Cuk

Publications and source records attributed to V Cuk.

45 records · Page 3Linked to original sources
PubMedDate not supplied

[Surgical treatment of toxic adenoma].

Sixty eight patients with toxic adenoma (TA) operated on in the period 1985-1992, were analyzed. The manifestation of hyperthyroidism in TA (in 55.88%) significantly depended on the gender of the patients (68.42% in men and 51.02% in women) and on the size of node. In nodes larger than 5 cm in diameter hyperthyroidism appeared in 76.92% of patients and in none with the nodes smaller than 2 cm. The degenerative changes in the nodes depended on pathohystological type of adenoma, and not on the size of nodes. On patohystological examination three carcinomas were found in TA, two papillary and one follicular. The surgical treatment of TA was the optimum way of treatment--the therapy of choice. Along with fast, complete and clear effects, the minimum percentage of complications (4.41%) developed that were mild and of short duration. The enucleation of nodes with capitonnage was absolutely sufficient in the operative treatment.

Adenoma↗
PubMedDate not supplied

[Abdominal war injuries].

In the period of July 1, 1991-December 31, 1992, 4292 wounded were treated in the Military Medical Academy (MMA) in Belgrade. Out of 410 (9.6%) wounded with abdominal war injuries, 156 (38%) received the primary treatment in MMA and the remainder in other hospitals. One fifth of the wounded with abdominal injuries suffered combined injuries of more organs and 82.7% of the cases had multiple injuries of one organ or combined injury of two or more abdominal organs. Wounding caused by explosive devices prevailed (61.5%), and the most frequently injured organs were small intestine in 40% and colon in 30.7% of the cases. Reoperation due to complications was performed in 7% of the wounded primarily managed in MMA and 33.8% of there primarily managed in other hospitals. Total mortality due to the abdominal war injuries was 10.9%, while mortality in patients primarily managed in MMA amounted to 4.5% compared to 14.9% of those operated on in other hospitals.

Abdominal Injuries↗
PubMedDate not supplied

[Comparative analysis of sutured and stapled colorectal anastomoses].

In the period of 1987-1993 at the Clinic of General and Vascular Surgery, Military Medical Academy, 364 colorectal anastomoses were performed; the group I was composed of 167 patients with sutured anastomoses, and 197 patients with stapled anastomoses were in the group II. More than half of patients were over 60, and ratio between males and females was 2:1. The reason for resection in almost 90% of the patients was adenocarcinoma of the rectum of which in 40% of the patients the process advanced up to stages C and D by Dukes. Pathologic process in the group I was localized in the lower two thirds of the rectum in 24.6% of the patients, while the percentage in the group II was tripled--76.1%. Surgical wound complications were most frequent in both groups (14.3%:9.6%), and complications associated with anastomosis were less frequent in the stapler group. Clinically clear anastomosis dehiscence appeared in 11.4% of the group I and in 10.7% of the group II. Total mortality was 3.3% (Group I 3.6%, group II 3.0%). By comparative analysis of early complications after resection of the rectum with sutured or stapled colorectal anastomosis, it is concluded that the introduction of staplers in colorectal surgery facilitated the easier accomplishment of larger number of low-lying colorectal or coloanal anastomoses, which are safer and followed by fewer complications, and with equal oncological disease control.

Adult↗
PubMedDate not supplied

[War injuries of the rectum and perineum].

The treatment results of 35 wounded with rectal and perineal lesion, treated in the period from 1991 to 1993 were analyzed retrospectively. In military hospitals, 82% of wounded were primarily surgically managed. The majority (65.8%) was with injury of intraperitoneal rectal segment, 10 patients (28.5%) were with the lesion of extraperitoneal segment and 2 patients (5.7%) were with the injury of anal tract and perineum. The injuries were mostly inflected by the bullets of various calibers (42.6%). Multiple or combined injuries were found in 91.6% of wounded with rectal injury and 38.2% of them were managed within 6 hours after injury. Different surgical procedures, most frequently the lesion suture and proximal colostomy (n = 14) were primarily used. Postoperative complications occurred in 10 wounded (28.6%). In 3 wounded it was reintervened by Hartmann's procedure. Mortality rate was 8.5% (n = 3). Anorectal war injuries are the most severe of all the colonic injuries. To our experience and the unique war surgical doctrine in the primary treatment of rectum injury, the most important is to perform terminal colostomy, injury suture (always intraperitoneal, and extraperitoneal if possible, including the sphincter muscles approximation) and presacral drainage.

Adult↗
PubMedDate not supplied

Discriminant analysis of pre- and intraoperatively detected prognostic factors influencing lymph node involvement in patients with colorectal carcinoma.

BACKGROUND/AIMS: The aim of this study was to establish whether, and to what extent, pre- and intraoperatively detected characteristics (demographic, anamnestic and laboratory data) and tumor characteristics can be used in the assessment of regional lymph node involvement in patients with colorectal carcinoma. The assessment also included the number of lymph nodes involved in patients with positive lymph nodes. Considering that the number of obtained lymph nodes widely varies in resected specimens, assessment parameters also included the percentage of the involved lymph nodes within the total population of lymph nodes. METHODOLOGY: From 1992-1993, 46 patients with carcinoma of the rectum and sigmoid colon were studied, with a total number of 736 lymph nodes evaluated. Out of the total number of lymph nodes, 577 (78.4%) were benign and 159 (21.6%), malignant. Data were analyzed by multi-variant statistical methods, namely: discriminant analysis and multiple regression with the aid of SPSS/PC+ software. RESULTS: For this patient group, we evaluated the following potentially predictive factors for lymph node involvement: age; serum hemoglobin, albumin and alkaline phosphatase levels; weight loss; and the primary tumor localization characteristics: histologic type, macroscopic growth pattern and depth of tumor invasion of the bowel wall. We found that there was no difference in the prediction of regional lymph node involvement between analysis of the aforementioned parameters and analysis of the isolated discriminators only. CONCLUSION: A predictability likelihood of 83.78% greatly surpasses the acceptable error tolerance level of 5%. Correlation of demographic, anamnestic and laboratory data about the patient and the characteristics of the primary tumor cannot be used in distinguishing malignant lymph nodes from benign ones. These data cannot be the basis for exact intraoperative staging and thus cannot be significant criteria for decision-making about operative treatment modalities.

Adenocarcinoma↗
PubMedDate not supplied

New surgical technique of omental pedicle graft preparation for omentomyelopexy.

Omental pedicle graft with left gastroepiploic vessels is very rarely used extraabdominally and all existing techniques of graft mobilization and lengthening are related to the graft with right gastroepiploic vessels. The aim of this research was to present the new surgical preparation technique of the omental graft based on the left gastroepiploic vessels for omentomyelopexy. First 100 patients, with injuries of spinal cord on different levels, were included in this prospective clinical study. In all these cases we performed omentomyelopexy with omental pedicle graft based on the new surgical technique of omental mobilization and lengthening. The results revealed that the way of preparation of omental pedicle graft depended on the level of the spinal cord lesion: in most cases for the lesions of cervical spinal cord the omental grafts had to be lengthened, for the midthoracic lesions omental graft was prepared without lengthening, while for the thoracolumbar lesions, only a part of omentum for graft was mostly used. The new surgical technique for preparation of omental pedicle graft for omentomyelopexy enabled the application of one of three possibilities for omentum lengthening. It depended on the type of omental vascularization, based on our own original classification and not on the level of spinal cord lesion. The preparation of omental pedicled graft with the left gastroepiploic vessels enabled the omentomyelopexy regardless of the level of spinal cord injury.

Adolescent↗