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Zdravko Perko

Publications and source records attributed to Zdravko Perko.

6 recordsLinked to original sources

Giant perianal angiomyofibroblastoma--a case report.

A 45-year old female had a long history of slow growing perianal tumor at the right side of her anus. Encapsulated tumour was found intraoperatively and completely excised using the Harmonic Scalpel. Tumour was well-circumscribed and relatively firm; measuring 12x6x4 cm. Histologically it was composed of oval to spindle cells with minimal nuclear atypia, set in mucous matrix with numerous thin-walled blood vessels. Immunohistochemically, expression of smooth-muscle actin and desmin, as well as estrogen and progesterone receptor were found in the tumour cells. The diagnosis of angiomyofibroblastoma was established. This rare benign tumour typically involves vulvovaginal, pelvic and perinal region. It is important to separate this neoplasm from locally invasive aggressive angiomyxoma and low grade fibromyxoid sarcoma, which can arise in the the same localisation. The patient was discharged on the third postoperative day and no recurrence was noted in 18 months follow-up.

Angiomyoma↗

Laparoscopic abdominal cysts fenestration using harmonic scalpel.

The use of ultrasonically activated scalpel for tissue cutting and coagulation is a potential replacement for electrosurgery, which can be related to different complications. Its working principle is to transform the electric power into the mechanical longitudinal movement of the working part of the instrument, by a piezoelectric transducer situated in the hand piece. Between October 2000 and June 2004, six patients with abdominal cysts were treated by laparoscopy, using the harmonic scalpel. The average age was 40.8 (ranging from 15-60) years. Laparoscopic abdominal cyst fenestration was performed in five patients, and laparoscopic cholecystectomy and abdominal cyst fenestration were done in one patient during the same operation. The average duration of the operation was 40 (ranging from 25-70) minutes and hospital stay was 2.8 (ranging from 1-5) days. Laparoscopic abdominal cyst fenestration using the harmonic scalpel is a safe and successful operation, with good results including all the advantages of the minimally invasive surgery.

Abdomen↗

[Catheter placement for peritoneal dialysis using videoendoscopy].

From December 1993 to December 2000 at the Department of Surgery, General Hospital "Sveti Duh", and University, Hospitals Split and Osijek the catheter for peritoneal dialysis was placed in 128 patients, in 137 cases. Videoendoscopic procedure, with the trocar made precisely for that purpose, was used. All surgical procedures, performed in the completely equipped operation room and in general anesthesia, were done without any intraoperative or postoperative complications. The procedure showed to have all advantages of endoscopic or minimally invasive surgery. The patients recovered quickly with low consumption of analgesics, got out of the bed and started with feeding sooner. There were no wound complications. It was possible to start with the dialysis 2-3 days after the procedure. Most important, the results showed that using this approach in comparison to others, there were no more dialysis solution leakages, catheter drainage problems, or more tunnel, exit site or peritoneal infections. Along with placing the catheter, other surgical procedures could be also done without increasing the complication rate. Therefore, laparoscopic cholecystectomy was done in 12 cases, adhesiolysis in 25 cases, and right adnexectomy, open hernioplasty and umbilical hernioplasty in one case. Videoendoscopic approach of placing the catheter is a simple, short and patient convenient procedure, with quick recovery and without any increase in complication rate.

Adult↗

[Education in endoscopic surgery: courses of endoscopic surgery in Split, Croatia].

Education is very important in endoscopic surgery. It can be performed on endoscopic trainers, live animals, and animal organs, using tissue samples or non-natural materials. Practical work and education can also be performed during the assistance or operating under the supervision. Endoscopic training courses have the important rule, too. We organized three endoscopic courses in Split up to date. The last one lasted 5 days, covered six different topics and included operations on pigs. In comparison with the course in the year 2001, the last course had more participants and lecturers. Lectures, practice and operations took longer time. The interest for attendance was high. The participants were very satisfied, and rated the lectures, practice and operations with the average grade between 4.1 and 4.7 on the anonymous questionnaire at the end of the course. It can be concluded that indispensable education in endoscopic surgery can be performed during endoscopic courses, where participants can reach basic theoretical and practical knowledge and skills. The courses should be permanently improved and modernized, providing a good quality, with interest and engagement of the attendees.

Animals↗

[Harmonic scalpel in laparoscopic surgery].

Harmonic scalpel for the tissue cutting and coagulating is a replacement for the high frequency current, which can be connected with diverse complications. The principle is transforming of the electric power into mechanical longitudinal movement of the working part of the instrument, by piezoelectrical transducer situated in the hand piece. Between October 2000 and June 2001, one hundred and three patients were operated using harmonic scalpel. The average age was 50.2 years. Laparoscopic cholecystectomy, appendectomy and abdominal cyste fenestration was performed in 86, 12 and 4 patients respectively. In one patient laparoscopic cholecystectomy and abdominal cyste fenestration were done during the same operation. The average hospital stay was 2.8 days. Laparoscopic cholecystectomy, appendectomy and cyst fenestration using the harmonic scalpel are safe and successful operations, with good results and advantages of the minimally invasive surgery.

Adolescent↗