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Vojkan Stanić

Publications and source records attributed to Vojkan Stanić.

10 recordsLinked to original sources
PubMed2006

[Failures and complications of thoracic drainage].

BACKGROUND/AIM: Thoracic drainage is a surgical procedure for introducing a drain into the pleural space to drain its contents. Using this method, the pleura is discharged and set to the physiological state which enables the reexpansion of the lungs. The aim of the study was to prove that the use of modern principles and protocols of thoracic drainage significantly reduces the occurrence of failures and complications, rendering the treatment more efficient. METHODS: The study included 967 patients treated by thoracic drainage within the period from January 1, 1989 to June 1, 2000. The studied patients were divided into 2 groups: group A of 463 patients treated in the period from january 1, 1989 to December 31, 1994 in whom 386 pleural drainage (83.36%) were performed, and group B of 602 patients treated form January 1, 1995 to June 1, 2000 in whom 581 pleural drainage (96.51%) were performed. The patients of the group A were drained using the classical standards of thoracic drainage by the general surgeons. The patents of the group B, however, were drained using the modern standards of thoracic drainage by the thoracic surgeons, and the general surgeons trained for this kind of the surgery. RESULTS: The study showed that better results were achieved in the treatment of the patients from the group B. The total incidence of the failures and complications of thoracic drainage decreased from 36.52% (group A) to 12.73% (group B). The mean length of hospitalization of the patients without complications in the group A was 19.5 days versus 10 days in the group B. The mean length of the treatment of the patients with failures and complications of the drainage in the group A was 33.5 days versus 17.5 days in the group B. CONCLUSION: The shorter length of hospitalization and the lower morbidity of the studied patients were considered to be the result of the correct treatment using modern principles of thoracic drainage, a suitable surgical technique, and a careful follow-up of the patients.

Chest Tubes↗
PubMed2006

[Stenosis of the right major bronchus from blunt trauma].

BACKGROUND: A severe blunt injury to the chest might cause rupture of the tracheobronchial tree. A certain time following the management of the injury, stenosis of the bronchi may develop at the site of the rupture. CASE REPORT: We reported a patient injured in a traffic accident. The injury was followed by the signs of pneumothorax, bleeding, and respiratory insufficiency. After the management of the injury using thoracal drainage, the condition of the injured was stabilized. Two weeks later, however, difficulties in breathing and fatigue occurred. Circular stenosis of the right major bronchus was clinically, radiographically and bronchoscopically confirmed. Right thoracotomy and circular resection of the major bronchus with termino-terminal anastomosis were performed. CONCLUSION: In severe blunt injuries to the chest, it is very important to suspect the injury of the tracheobronchial tree in order to correctly understand the clinical signs of an injury and to interprete a radiographic image of it, so as to decide upon the optimal treatment on time.

Accidents, Traffic↗
PubMed2006

[Descending necrotizing mediastinitis].

BACKGROUND: [corrected] Descending necrotizing mediastinitis (DNM) is an acute, serious, septic disease which results from a complication of oropharyngeal infection. The disease requires a prompt diagnosis and radical surgical treatment to reduce high mortality (40%). The optimal form of mediastinal drainage remains conroversial. The reason for publishing this report is both the fact that DNM is very rare and our experience prefering thoracotomy as an optimal approach to treating the disease. CASE REPORT: We reported a 34-years-old woman with DNM. The disease began as a peritonsillar abscess. After a bilateral double pleural drainage the disease worsened. In order to achieve radical mediastinal debridement and drainage, we carried out posterolateral right thoracotomy. We also had to perform left thoracotomy bacause of massive bleeding coused by septic erosion. There were no more reoperations. CONCLUSION: Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis.

Humans↗
PubMedDate not supplied

[Necrotizing fasciitis caused by group A streptococcus].

The first case of the confirmed necrotizing fasciitis caused by Group A Streptococcus in Yugoslavia was presented. Male patient, aged 28, in good health, suddenly developed symptoms and signs of severe infective syndrome and intensive pain in the axillary region. Parenteral antibiotic, substitutional and supportive therapy was conducted along with the radical surgical excision of the necrotizing tissue. The patient did not develop streptococcal toxic shock syndrome thanks to the early established diagnosis and timely applied aggressive treatment. He was released from the hospital as completely cured two months after the admission.

Adult↗
PubMedDate not supplied

[Diagnostic thoracoscopy].

Diagnostic thoracoscopy in patients with pleural effusion of unclear origin mostly provides the correct diagnosis. Results from published reports of previous researches are not uniform. In 47 male and 20 female patients with pleural effusion of unknown etiology, after receiving negative results obtained from cytological finding of pleural effusion and percutaneous needle biopsy, thoracoscopy with biopsy of one or both pleurae was performed. Procedure was done in local anesthesia using Stortz rigid thoracoscope. In 37 patients with malignant disease (primary or metastatic) diagnosis was confirmed histopathologically in 31 patient (81.12%). In 27 patients with inflammatory pleural disease diagnosis was confirmed histopathologically in 22 patients (81.4%). Among 11 patients with specific pleural effusions, tuberculosis was confirmed in 10 (90.91%). Normal finding in cases of spontaneous pneumothorax and pulmonary embolism was taken as a positive result. Total number of positive findings was 55 (82.10%). In one patient, the third spontaneous pneumothorax was the indication for thoracoscopy, and after numerous bullae were seen during the procedure, talcum powder pleurodesis was done. In four patients low intensity subcutaneous emphysema occurred one day after thoracoscopy. It can be concluded that thoracoscopy in local anesthesia out of the operating room is good and practical method for solving the unclear pleural effusions, with neglectable rate of complications.

Adult↗
PubMedDate not supplied

[Chylous effusions].

This paper presents 4 patients with chylothorax, and one patient with bilateral chylothorax and chyloperitoneum. The chylous effusions were of benign etiology, developed as a complication of miliary tuberculosis (1 patient), after L-2 vertebral body fracture (1 patient), and idiopathic (2 patients). The diagnosis was confirmed by the presence of chylomicrons and high content of triglycerides in the effusion, ranged 11.9-29.1 mmol/l. Lymphangiography showed multiple abnormalities of lymphatic system, the obstruction of ductus thoracicus, dilatation and convulsion of lymphatic channels, but the site of lymphatic leak was not detected. The treatment included an extended period of pleural and peritoneal drainage with total parenteral nutrition (1 patient), pleurodesis using Corynebacterium parvum (2 patients), and surgical partial parietal pleurectomy with continuous drainage (1 patient). The treatment was successful in all patients.

Adult↗