Browsing by Author "Radovanović, Dragan (36087908200)"

Introduction. An inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor of unclear etiology, which demonstrates myofibroblastic differentiation accompanied by inflammatory cells. IMT is a frequent primary lung tumor in children and is of nonspecific symptomatology and imaging methods. Its definitive diagnosis requires histopathology and immunohistochemistry of the tissue sample obtained after a rigid bronchoscopy or after complete surgical resection. Case report. A 16-year-old male patient was admitted to our clinic for further treatment of IMT verified by rigid bronchoscopy. He had previously been treated at another institution for left-sided pneumothorax with thoracic drainage. Since it had not resulted in lung reexpansion, a chest computed tomography was performed followed by rigid bronchoscopy that eventually established IMT diagnosis in the distal part of the left main bronchus. Since the tumor surrounded the left lobar carina and infiltrated the pulmonary artery, pneumonectomy was undertaken. Its morphology and immunoprofile determined the IMT diagnosis. Four years after surgical resection, the patient showed no recidivism of the illness. Conclusion. IMT is one of the most frequent primary lung tumors in children and needs to always be suspected upon. Pneumothorax can appear as an IMT manifestation. Its occurrence could be the consequence of either a visceral pleura lesion in case of peripheral tumors or a ball valve mechanism in case of endobronchial tumors. Definitive diagnosis of IMT requires not only histopathology but also immunohistochemical analysis. Complete surgical resection results in the best survival rates. Further monitoring of patients is necessary due to the risk of recurrence. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. In colon and rectal cancer surgery, resection is considered radical when circumferential, proximal and distal resection margins are without the presence of tumor cells. Concept of total mesorectal excision in rectal surgery involves complete removal of the tumor with mesorectal fascia which surrounds lymph nodes, lymphatics and blood vessels. The aim of this study was to determine whether laparoscopic approach provides all parameters of oncological radicality as open surgery of colorectal cancer. Methods. The study included 122 patients with carcinoma of colon and rectum, divided into two equal groups: patients operated on by laparoscopic and those operated on by open approach. In colon surgery we analyzed proximal and distal resection margins, and the number of removed lymph nodes, and in rectal surgery: proximal, distal and circumferential resection margins, and the number of removed lymph nodes. Results. Both groups were comparable in age, sex, American Society of Anesthesiologists (ASA) score, tumor localization, tumor size, and type of surgical operation performed. According to localization of the tumor, the most commonly performed operation was anterior resection of the rectum (60.7% vs. 59%). There was no case of the tumor involvement of the distal margin. Average proximal distance from the tumor on the fixed specimen was 100 vs. 120 mm with statistical significance (p < 0.001). Distal margins were not significantly different, 40 mm in both groups (p = 0.143). In two cases we had circumferential resection margin (CRM) of 1 mm (7.7%) in the laparoscopic group, and in three cases operated conventionally CRM was 1 mm (8.8%). The average number of removed lymph nodes was 15 vs. 16, respectively. Length of hospital stay for patients assigned to the laparoscopic surgery was significantly shorter than for patients operated on by the open approach. Concerning postoperative complications, no significant difference was found between groups. The overall postoperative morbidity was 18% vs. 21.3%, respectively. Conclusion. With laparoscopic approach it is possible to provide all parameters of oncological radicality similarly to the open surgery of colorectal cancer. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction Specific morphological and functional characteristics of athletes have a significant role in determining athletes' sports results and can be also used to assess the athlete's individual potential. Objective The aim of the study was to compare anthropometric characteristics and cardiovascular parameters in trained subjects to those of untrained subjects. Methods A total number of 25 trained (17.30±}0.83 years) and 21 (18.52±}1.52 years) untrained male subjects participated in this study. Body weight and height were measured and these values were used to compute body mass index (BMI). The bioelectrical impedance analysis (BIA) method was used to estimate body fat percentage (%BF). Cardiovascular parameters were monitored in rest (rest heart rate, systolic and diastolic blood pressure) during ergospirometric testing (maximal oxygen consumption, maximal heart rate) and in recovery (heart rate in the first and third minute of recovery). Results Body mass, height and BMI (p<0.01) were significantly higher, although BF% was lower in trained group when compared to untrained, but the difference was not statistically significant. Heart rate in rest and recovery were significantly lower (p<0.05) in trained group when compared to untrained, although maximal oxygen consumption and maximal heart rate were significantly higher in trained group (p<0.01, p<0.05, respectevely). Conclusion Our results show that in trained subjects, water polo players, regular intense physical activity lead to adaptive changes of anthropometric parameters and adaptive changes on the cardiovascular system.

Pulmonary artery intimal sarcoma (PAS) is a rare mesenchymal tumor mostly diagnosed in middle-aged women. In a 63-year-old female, the radiological findings showed cavitation in the left upper lobe of the lung and infiltrative tumor mass around the left pulmonary artery. PAS consisted of small, round tumor cells with about 80% of mitotic activity and with myxoid background and specific immunoprofile and diagnosed as undifferentiated sarcoma with round cell features type. The final diagnosis of PAS was established according to the pathohistological, chest computed tomography scan, and surgery finding. © 2018 Journal of Research in Medical Sciences | Published by Wolters Kluwer - Medknow.

Introduction Intraductal papillary mucinous neoplasms (IPMN) are among the most common cystic neoplasms of the pancreas, but they represent only 1–3% of all exocrine pancreas tumors. With the development of diagnostic possibilities the number of patients with IPMN is constantly increasing and represents approximately 20% of all surgically treated pancreatic tumors. The development of laparoscopic surgery has led to advances in the treatment of cystic tumors of the pancreas with the emergence of new surgical dilemma in the choice of surgical techniques in patients with IPMN. Case Outline A 23-year-old patient was admitted to the hospital with non-specific symptoms of upper abdomen. Performed diagnostics indicated the existence of a tumor formation at the periphery of the pancreas, in the region of the proximal corpus, 8×5 cm in diameter. The cystic formation, wall thickness 3 mm, was filled with dense contents and injected into the tissue of the pancreas, but did not lead to an extension of the pancreatic duct. After adequate preoperative preparation the patient was operated on, when a laparoscopic enucleation of cystic tumor with coagulation and cutting off communication between the peripheral pancreatic duct and pancreatic tumors was performed by using ultrasound scissors. Histopathological analysis of the specimen indicated an IPMN of the branch duct type (BD-IPMN) with a low grade dysplasia. The line of resection was without cellular atypia. Immunohistochemical analysis showed positivity on tumor mucins (MUC-5 and MUC-2), which is typical for gastric type of BD-IPMN. Six months postoperatively the patient showed no signs of recurrence of the disease. Conclusion Surgical treatment is the dominant choice for the treatment for IPMN. Although minimally invasive, laparoscopic enucleation of BD-IPMN is able to achieve an adequate level of radicality without the accompanying complications and with short postoperative recovery period. © 2015, Serbia Medical Society.

Introduction Unilateral absence of pulmonary artery is a rare vascular malformation. Because of this anomaly, the lungs are supplied by the system of collateral arteries. Case outline We present a case of the right pulmonary artery agenesis in a female patient. She was admitted to the hospital because of hemoptysis. A computed tomography scan revealed a congenital malformation – the right lung was smaller in size, the right principal pulmonary artery had not been developed along with aberrant tortuous blood vessels. Conclusion Symptomatic therapy was applied in the case of our patient. There was no need for any surgical treatment. However, in case of massive hemoptysis embolisation or lobectomy/ pneumonectomy will probably be applied. © 2019, Serbia Medical Society. All rights reserved.