Acta chirurgica Iugoslavica最新文献

{"title":"Trans-Obturator-Tape (T.O.T.) \"outside-in\" approach in surgical treatment of female stress urinary incontinence.","authors":"M Jovanović,&nbsp;Z Džamić,&nbsp;M Aćimović,&nbsp;B Kajmaković,&nbsp;T Pejčić","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to analyzed the efficacy and safety of a minimally invasive surgical procedure using the Trans- Obturator-Tape with \"outside-in\" approach for treatment female stress urinary incontinence.</p><p><strong>Patients and methods: </strong>171 women with stress urinary incontinence (SUI) associated with urethral hypermobility, underwent the T.O.T. procedure (March 2010 to January 2014). 27 patients were previously operated for incontinence. Mean age was 59 years (37-80). 6 patients were having mixed incontinence, and 51 had SUI with urgencies. A non-elastic, polypropylene tape was placed under the mid-urethra. The surgical placement technique utilises a trans-obturator percutaneous approach. All patients underwent post-operative clinical examination, cough-stress test (full bladder), uroflowmetry, and post-voiding residual assessment.</p><p><strong>Results: </strong>Mean follow-up was 22 months (4-45). At 12 months follow-up 91,2% of the patients were completely cured. The overall peri-operative complication rate was 6.4% with no vascular, nerve or bowel injury. 5 patients (2.9%) had post-operative urinary retention.</p><p><strong>Conclusion: </strong>The present study confirms the results obtained by the instigator of the technique, E. Delorme, and allows us to consider T.O.T. as an effective and safe technique for the treatment of female stress urinary incontinence.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33014420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of IAEA software package for the analysis of scintigraphic renal dynamic studies: Preliminary results for semi-quantitative parameters of technetium-99m mercapto-acetyltriglycine renogram in healthy individuals","authors":"S. Beatovic, D. Šobić-Šaranović, E. Jaksić, J. Marinkovic, M. Janković, V. Artiko, V. Obradović","doi":"10.2298/aci1403033b","DOIUrl":"https://doi.org/10.2298/aci1403033b","url":null,"abstract":"The aims of this study in healthy individuals were: a) to implement the International Atomic Energy Agency (IAEA) Software Package into analysis of technetium-99m mercapto-acetyltriglycine (99mTc MAG3) dynamic scintigraphy, b) to validate results of renogram parameters against their reference values, and c) to compare different renogram indices of kidney excretion in order to assess whether the clinical information provided by all of them is identical. Study population consisted of 20 healthy subjects who were evaluated by 99mTc MAG3 dynamic scintigraphy for kidney donation. The IAEA software was applied to process the studies. The parameters analyzed were: time to maximum activity (Tmax), time to half maximum (T1/2) of the curves, normalized residual activity at 20 minutes (NORA 20), output efficiency at 20 minutes (OE 20), residual activity (RA), elimination index (EI), whole kidney mean transit time (MTT), mean parenchymal transit time (MPTT) and relative kidney function (RF). Correspondence between OE 20, NORA 20, RA and EI was evaluated by Pearson correlation coefficient and linear regression analysis. The results for normal kidneys were presented as follows: Tmax: 3.4+0.7 min; T1/2:6.1+1.5min; NORA20:0.34+0.09;OE20: 93+2.2%; RA: 26+6.2%; EI: 2.2+0.4; MTT: 2.+0.4 min and MPTT: 1.7+0.4 min. Relative function for the left and right kidney was 52% and 48%+.4%, respectively. The excellent agreement was observed between the obtained values of renogram parameters and their reference values. Significant linear correlation between parameters of kidney excretion was obtained. The highest correlation was observed between NORA 20 and OE 20 (r=-0.936, p< 0.01). In Conclusion, the IAEA Software gives reliable values of numerical parameters of kidney excretion. Results obtained for normal kidneys were almost identical with previously reported reference values for MAG3 parameters. Only the results for MTT and MPTT were systematically lower than the established normal values. NORA 20 highly corresponds with OE 20 and could replace the former parameter in the evaluation of kidney drainage. The preliminary results support the wide-spread use of IAEA software package in order to standardize the technique of dynamic renal scintigraphy. [Projekat Ministarstva nauke Republike Srbije, br. 175018]","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68392859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative surgical treatment of uterine fibroids","authors":"R. Sparić, L. Nejković, Dragoslav Mutavdžić, A. Malvasi, A. Tinelli","doi":"10.2298/ACI1404011S","DOIUrl":"https://doi.org/10.2298/ACI1404011S","url":null,"abstract":"Fibroids are the most common benign tumours of the genital organs in women of childbearing age, causing significant morbidity and largely disturbing quality of life. Myomectomy is a option of choice for women who want to preserve reproductive function. Conventional myomectomy via laparotomy is commonly used for large subserosal and intramural fibroids and in cases of a large number of fibroids. Number, size and location of fibroids in most cases do not represent a limiting factor for conventional myomectomy. Vaginal myomectomy is possible in cases of nascent submucosal fibroids. Laparoscopic myomectomy is an option for patients with smaller uterus, as the size of the uterus could represent a limiting factor for this approach. Hysteroscopic resection of submucosal fibroids is the method of choice for most patients with submucous fibroids. There is no consensus yet on the maximum size and type of fibroids that can be operated with this approach. Myoma pseudocapsule research during the past decade led to introduction of a surgical technique called \"intracapsular myomectomy\", as a method which spares the pseudocapsule as an important structure for optimal myometrial healing after myomectomy, positively affecting future reproductive function. The clinical rationale for intracapsular myomectomy can be applied to all myomectomies, therefore it has been used both for laparoscopic and laparotomic myomectomy, as well as for cesarean myomectomy. Several studies demonstrated that CM is probably safer procedure than previously believed. CM is justifiable when performed following proper patient selection by experienced surgeons.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68392811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radio-guided parathyroidectomy for recurrent renal hyperparathyroidism caused by graft hyperplasia","authors":"Z. Lončar, K. Taušanović, N. Kozarevic, V. Živaljević, B. Oluić, I. Paunović","doi":"10.2298/aci1403073l","DOIUrl":"https://doi.org/10.2298/aci1403073l","url":null,"abstract":"Radio-guided surgery offers several advantages in treatment of primary hyperparathyroidism. It is considered less helpful in renal hyperparathyroidism, but it could be of great advantage in the treatment of persistent or recurrent secondary hyperparathyroidism. One of the surgical options for symptomatic renal hyperparathyroidism is total parathyroidectomy with autotransplantation of hyperplastic parathyroid tissue in forearm muscles or sternocleidomastoid muscle. Recurrence can occur and is most likely caused by graft hyperplasia. In this report we present the case of 54-year-old woman with recurrent renal hyperparathyroidism caused by hyperplasia of the graft in sternocleidomastoid muscle. Unfortunately no sutures or clips were placed at initial surgery to identify the location of the parathyroid tissue. The preoperative assessment consisting of 99mTc-sestamibi scintigraphy identified a parathyroid tissue in the in the middle third of sternocleidomastoid muscle. The patient underwent a radio-guided neck re-exploration that allowed a rapid localization and excision of the hyperplastic graft.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"71 1","pages":"73-76"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation in children of the standard diuretic renogram with furosemide at 20min, as compared to the diuretic renogram with furosemide after 2min","authors":"S. Beatovic, D. Šobić-Šaranović, E. Jaksić, J. Marinkovic, M. Janković, V. Artiko, V. Obradović","doi":"10.2298/aci1403057b","DOIUrl":"https://doi.org/10.2298/aci1403057b","url":null,"abstract":"Purpose: The aims of this study in children were a) to compare the renogram with furosemide at 20min (F+20) with the renogram obtained by injecting furosemide after 2min (F+2) and b) to define the normal values of parameters for the technetium-99m mercapto-acetyl-triglycine (99mTc MAG3) diuresis renography. Patients and Methods: The investigation was carried out on the sample of 77 children: 41 boys and 36 girls (median age: 26 months, age range 2-120 months) with unilateral antenatally detected hydronephrosis (HN) and contralateral normal kidney. They were divided into two groups. Group 1 consisted of 33 children who underwent standard F+20 diuresis renography, and Group 2 of 44 children with F+2 renography. Only the normal kidneys were included in the analysis. In total, 77 kidneys were analyzed. The International Atomic Energy Agency (IAEA) software package was applied to process the studies and the following parameters were analyzed: Tmax, diuresis nephrogram in children have been calculated by the means of the IAEA software. Applying these values to semi-quantitative MAG3 parameters may help in differentiation between normal and abnormal finding of diuresis renography in children. The semi-quantitative parameters facilitate the comparison between studies during follow/up and contribute to better management of children with HN. [Projekat Ministarstva nauke Republike Srbije, br. 175018]","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"44 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68392980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of antibiotic related and clostridium difficile colitis","authors":"N. Haboubi, Z. Krivokapic","doi":"10.2298/aci1402065h","DOIUrl":"https://doi.org/10.2298/aci1402065h","url":null,"abstract":"Nearly all antibiotics can cause some form of diarrhoea. Clostridium difficile infection has become an important area in our daily clinical practice and is known to cause a broad spectrum of conditions ranging from asymptomatic carriage to the life-threatening pseudomembranous colitis (PMC), with toxic megacolon and ileus. Patients most at risk are those who have been treated with broad spectrum antibiotics, those with serious underlying co-morbidities and the elderly. Over 80% of Clostridium difficile infection reported are in people aged over 65 years. Combination of rapid and accurate diagnosis will result in a better management of Clostridium difficile infection. Discontinuation of causative agents such as antibiotic treatment is often curative. In more serious cases, oral administration of metronidazole or vancomycin is the treatment of choice. Patients should be treated promptly when the diagnosis of Clostridium difficile colitis is made to avoid sepsis or bowel perforation. Relapses of Clostridium difficile infection have been reported in about 20-25% of cases, this may increase to 45-60% after the first recurrence on. In some cases colectomy may improve the outcome of the patient with systemic infection or complicated Clostridium difficile colitis. This article reviews the current literature regarding epidemiological picture, microbiology, histopathology and both medical and surgical managements.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"65-70"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68392429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiopathogenesis, diagnostics and history of surgical treatment of stress urinary incontinence.","authors":"Hadži-Djokić Jovan, Babić Uroš, Argirović Aleksandar, Aćimović Miodrag, Radovanović Milan, Milojević Bogomir, Pejčić Tomisla, Džamić Zoran","doi":"10.2298/ACI1401085H","DOIUrl":"https://doi.org/10.2298/ACI1401085H","url":null,"abstract":"Urinary incontinence represents involuntary urine leakage into the urethra. This pathological condition represents a major medical, social and hygienic problem. The paper presents risk factors for development of the disorder, as well as diagnostic methods applied in evaluation of the female patients. Chronological review of diverse surgical techniques used in treatment of stress urinary incontinence reported in the published scientific papers is also presented. Review of the literature data was also performed. Sling procedures with application of suburethral loops have been used since the beginning of the last century in treatment of this disorder. Surgical treatment of stress urinary incontinence is applied when conservative treatment fails to give any effects according to strictly defined indications. During the last 100 years, surgical techniques have undergone different improvements and the results have also been significantly improved.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1 1","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68392553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary tract injury associated with pelvic fractures.","authors":"Saša Milenković,&nbsp;Milan Mitković,&nbsp;Dragoslav Bašić,&nbsp;Stojanka Arsić,&nbsp;Jovan Hadži Djokić,&nbsp;Milorad Mitković","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic trauma associated with urinary tract injury is a severe trauma, mostly caused by traffic accidents and falls from heights. These injuries require urgent treatment and close teamwork between urologic and orthopaedic surgeons.</p><p><strong>Material and methods: </strong>In this retrospective study there were analyzed patients with pelvic trauma and extraperitoneal injury of urinary tract, treated surgically at Clinic for Ortopaedic Surgery and Traumatology and Urology Clinic in Clinical Center Nis. Surgical intervention in these patients had been realized as the synchronized work of both orthopaedic and urologic surgeons. The pelvis was treated by external and internal fixation. Mitkovic type external fixator was used for pelvic external fixation. Plating was used for pelvic internal fixation. Pelvic fractures were classified using Tile's classification system. The final functional results had been scored using Majeed score system.</p><p><strong>Results: </strong>There were 42 patients with the injury of pelvic ring, treated at Clinic for Ortopaedic Surgery and Traumatology and at Urology Clinic, Clinical Center Nis, in the period of 01.01.2011. to 31.12.2013, 30 males and 12 females, with average age of 53.69 (19-84) years old. In 80% of cases pelvic fractures were caused by high energy trauma in traffic accidents. According to Tile's classification, 9 patients (21,42%) had pelvic fracture type A, 23 patients (54,46%) had pelvic fracture type B and 10 patients (23,80%) had pelvic fracture type C. Urinary tract injury was diagnosed in 9 patients (21,42%): 5 patients (11,9%) with bladder injury, 3 patients (7,14%) with posterior urethra injury and 1 patient (2,38%) with both bladder and posterior urethra injury.</p><p><strong>Conclusion: </strong>Urgent repair of extraperitoneal urinary tract injury by urologic surgeons and synchronized pelvic reduction and fixation using external or internal fixation by ortopaedic surgeon, in the same surgical procedure, is the standard method for treatment of this severe injury.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"9-15"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33140034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sigma-rectum pouch (Mainz pouch II).","authors":"Jovan Hadžić Djokić,&nbsp;Bogomir Milojević,&nbsp;Tomislav Pejčić,&nbsp;Miodrag Aćimović,&nbsp;Vladimir Stamenković,&nbsp;Zoran Džamić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Mainz pouch II is a well tolerated form of continent urinary diversion in terms of morbidity, protection of the upper urinary tract and continence rate, even in patients aged > 65 years. Mainz pouch II was described by Fisch and Hohenfellner in 1991. They viewed the simplicity and reproducibility of the operation as one of its major advantages. A good continence rates between 93%-100% after this procedure has been shown in previous studies. The longer follow up will show whether these high rates of continence can be maintained with increasing age. The Mainz Pouch II serves as a satisfying continent urinary diversion for both sexes in selected patients in terms of quality of life. Evaluation of overall quality of life in patients with Mainz pouch II urinary derivation has given encouraging results. Compliance and cooperation of the patients, together with preoperative tests for anal competence, are mandatory to avoid complications. The Mainz group reported that the overall complication rate was low and comparable with other techniques of continent urinary diversion. During the past years modifications of the original technique have been described. These represent an increasing interest in the procedure. Today, the techniques of low-pressure and reservoirs have completely replaced classical ureterosigmoidostomy. In this review article the main focus is aimed at history, complications, continence and quality of life of patients with Mainz pouch II.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33014413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Camey-Le Duck ureteral reimplantation technique in modified ureterosigmoidostomy (Mainz pouch II) urinary diversion.","authors":"Dragoslav Bašić,&nbsp;Ivan Ignjatović,&nbsp;Milan Potić,&nbsp;Miladin Radovanović","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>to analyze complications and clinical outcome of Camey-Le Duck ureteral reimplantation technique in modified Mainz pouch II urinary diversion.</p><p><strong>Patients and methods: </strong>this retrospective study included a total of 110 patients (101 male and 9 female, mean age 59.2 years, SD = 10.2), who had underwent a modified Mainz pouch II urinary diversion with Camey-Le Duck ureteral reimplantation technique, following total cystectomy, during the period 1995-2014. The mean follow-up, available for 90 (82%) patients period was 19 (1-74) months. Early and late postoperative complications were analyzed.</p><p><strong>Results: </strong>early complications developed in 22 (20%) patients as follow: unilateral ureterohydronephrosis in 8 (7%) patients, bilateral ureterohydronephrosis in one (1%)-two RU (renoureteral units), urinary leakage in 8 (7%), and pyelonephritis in 5 (5%) patients. Late complications developed in 28 (25%) patients: pyelonephritis in 17 (15%), and ureteral reimplantation site stenosis in 11 (10%) patients with 12 RU. Balloon dilatation procedure was applied in all 12 RU, with additional metallic Strecker stent insertion in 5 RU. At 24-month follow-up, all patients with metallic Strecker stent had normal results of serum biochemistry, blood gas analysis and renal ultrasound. In the rest of six patients with 7RU, balloon dilatation has failed and restenosis of ureteral reimplantation site with consequent ipsilateral hydronephrosis was verified. In these patients, permanent percutaneous nephrostomy catheter was applied.</p><p><strong>Conclusion: </strong>Camey-Le Duck ureteral reimplantation technique following Mainz pouch II urinary diversion is simple, reliable and durable. It enables well upper urinary tract protection and is associated with relatively low major complication rates.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"95-101"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33020024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}