Browsing by Author "Juloski, Jovan T. (57216998788)"

Pancreatic ductal adenocarcinoma (PDAC) represents an aggressive tumor with a low five-year survival rate of less than 10%. Only 20% of patients are estimated to be eligible for upfront curative resection at the time of presentation. The larger group of borderline resectable (BRPC) and locally advanced pancreatic cancers (LAPC) had much poorer outcomes in the past. Although there are improvements for the multimodal therapy of PDAC, surgery remains the single hope for a cure. Combined with adjuvant and/or neoadjuvant treatment, pancreatic surgery can enhance five-year survival by up to 20%. However, pancreatic resection is widely associated with a high risk of complications and is regarded as one of the most complex surgical procedures. TRIANGLE operation should be added to pancreatic surgery armamentarium as a key procedure, with the potential to increase the number of harvested lymph nodes, reduce the complications rate, and better radical treatment efficacy for BRPC and LAPC be converted to resectability after neoadjuvant treatment (NAT). More and more aggressive pancreatectomy has become justified in the context of NAT. Further technical standardization and optimal neoadjuvant strategy are mandatory for the global dissemination of aggressive pancreatectomies. This review summarizes the surgical treatment for BRPC and potentially resectable LAPC based on the current literature, focusing on the "TRIANGLE "concept of pancreatic surgery. Copyright © Celsius.

Purpose: Colorectal cancer represents the second most common type of cancer in Serbia. Alteration of lipid metabolism begins early, and can represent a central hallmark in cancer evolution. Fatty acids have various important functions as building components of cell membranes, as signaling molecules in immune responses and also manage the general cancer signaling network. The purpose of this study was to investigate the difference of various fatty acids content between colorectal cancer and adjacent healthy intestinal tissue in adult and aged patients of both sexes. Methods: 52 subjects participated in this study. Healthy colon mucosa and tumor tissue samples were obtained from patients previously diagnosed with colorectal carcinoma. Simplified method of Berstad et al was used for direct transesterification of total lipids in tumor and healthy mucosa tissue samples and separations of the methyl esters was carried out using a gas chromatograph equipped with a split/ splitless injector and a flame ionization detector. Results: 18 0, 18 1 n7, 20 3, 20 4, 20 5, 22 4, 22 5 22 6, SFA, PUFA, n6, n3 and AA/EPA were significantly higher in tumor tissue. On the other hand, 18 1 n9, 18 2, 18 3 n3, MUFA, n6/ n3 were significantly higher in healthy tissue. Conclusions: Saturation index (SI) could be a valuable tool to delineate robust immune response and worse prognosis in patients with colorectal cancer. Our study demonstrated significant differences in fatty acid profiles between tumor tissue and healthy mucosa. Parameters, such as gender, age, stage and mucinous component didn't influence altered fatty acid content. © 2021 Zerbinis Publications. All rights reserved.

Purpose: Colorectal cancer represents the second most common type of cancer in Serbia. Alteration of lipid metabolism begins early, and can represent a central hallmark in cancer evolution. Fatty acids have various important functions as building components of cell membranes, as signaling molecules in immune responses and also manage the general cancer signaling network. The purpose of this study was to investigate the difference of various fatty acids content between colorectal cancer and adjacent healthy intestinal tissue in adult and aged patients of both sexes. Methods: 52 subjects participated in this study. Healthy colon mucosa and tumor tissue samples were obtained from patients previously diagnosed with colorectal carcinoma. Simplified method of Berstad et al was used for direct transesterification of total lipids in tumor and healthy mucosa tissue samples and separations of the methyl esters was carried out using a gas chromatograph equipped with a split/ splitless injector and a flame ionization detector. Results: 18 0, 18 1 n7, 20 3, 20 4, 20 5, 22 4, 22 5 22 6, SFA, PUFA, n6, n3 and AA/EPA were significantly higher in tumor tissue. On the other hand, 18 1 n9, 18 2, 18 3 n3, MUFA, n6/ n3 were significantly higher in healthy tissue. Conclusions: Saturation index (SI) could be a valuable tool to delineate robust immune response and worse prognosis in patients with colorectal cancer. Our study demonstrated significant differences in fatty acid profiles between tumor tissue and healthy mucosa. Parameters, such as gender, age, stage and mucinous component didn't influence altered fatty acid content. © 2021 Zerbinis Publications. All rights reserved.

SUMMARY Introduction In the world with constantly increasing incidence of violence and trauma on one side, and more and more specialized surgeons on the other, the question about the role of abdominal surgeons in cardiac trauma emerges. The objective of this article is to show personal experience of an abdominal surgeon in managing heart trauma. Outlines of cases We present two penetrating injuries and one blunt trauma of the heart successfully managed by an abdominal surgeon. Conclusion Abdominal surgeons should feel comfortable with the decision to operate on greatly physiologically deranged patients with penetrating chest trauma, and not to delay the operation with conservative measures or with time-consuming transport to remote specialized facilities, since that could lead to greater death percentage of these patients. © 2021, Serbia Medical Society. All rights reserved.

Introduction Leiomyosarcoma of the inferior vena cava (IVC) is a rare mesenchymal tumor originating from the endothelial smooth muscle of the intima and account for about 1–2% of all the sarcomas of the soft tissue. The objective of this article is to show a case of IVC leiomyosarcoma, it’s resection and reconstruction using a ProxiCor patch. Case outlines We showed a case of a 65-year-old woman presented with abdominal pain and mass in subhepatic space, who underwent surgery and resection of a leiomyosarcoma of IVC. IVC was recon-structed with ProxiCor patch, and histopathologically confirmed that it was leiomyosarcoma. Conclusion Our experience has shown that the application of extracellular matrix is safe and has given a satisfactory treatment result. A comparison with a larger patient sample should give a true representa-tion of the advantages and disadvantages of this type of material in vascular reconstructive procedures. © 2023, Serbia Medical Society. All rights reserved.

Peritonitis is one of the most important sources of abdominal sepsis. Since intra-abdominal infection leads to the activation of the inflammatory response, this suggested that some of these mediators could be used as markers of the severity of newly formed sepsis, but primarily to identify or rule out new-onset sepsis. The aim of this study was to evaluate the sensitivity and specificity of serum markers of inflammation: C-reactive protein, procalcitonin and serum amyloid A in the serum of patients with diffuse secondary peritonitis. The prospective cohort study was conducted at the Clinic for Emergency Surgery of the Clinical Center of Serbia in Belgrade. The study group consisted of 100 patients aged 18 to 70 years, with signs of acute abdomen due to diffuse secondary peritonitis. CRP and PCT are so far among the most valuable preoperative markers for distinguishing sepsis from SIRS. On the first postoperative day the analysis of the relationship between sensitivity and specificity at the different breakpoints used indicates a greater diagnostic accuracy and greater sensitivity of SAA compared to CRP and PCT. In the remaining postoperative period in our study, the ROC curve mostly coincided with the diagonal line, so CRP, PCT, and SAA had little diagnostic accuracy. The results of our study suggest that finding a specific marker for the diagnosis of abdominal sepsis, a marker that would differentiate between SIRS and sepsis, pre- and postoperatively, would be very useful. Copyright © Celsius.

Jaundice may result from various illnesses, among which obstruction of the biliary tree is the main surgical focus. Cholangitis is generally associated with infection in the presence of biliary obstruction. Cholangitis occurs when partial or complete obstruction of the bile duct exists, resulting in increased intraluminal pressure and infected bile proximal to the obstruction. Patients with cholangitis may present with right upper quadrant abdominal pain, fever, and/or jaundice (Charcot’s triad); patients with “toxic” cholangitis—Charcot’s triad plus shock and mental confusion (Reynold’s pentad). Diagnosis is based on physical examination and laboratory testing, and with help of radiologic imaging the cause can be revealed. Previous option for the relief of obstructive jaundice was operative intervention. Today, the surgeon must determine the safest and most effective therapy for each patient and prepare them for surgery or nonoperative therapeutic intervention (stenting, balloon dilation, sphincterotomy). All patients being treated for cholangitis should be resuscitated, electrolyte imbalances corrected, IV antibiotics administered, and closely monitored. After resuscitation, imaging of the biliary tree is needed in order to find the location and cause of the obstruction. Further management is conducted accordingly. However, it cannot be stressed enough that the definitive treatment for cholangitis is biliary decompression. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.