Search PubMed⌕ Search

Biomedical subjects

D Stevović

Publications and source records attributed to D Stevović.

11 recordsLinked to original sources
PubMed2002

Local recurrence and five year survival after abdominoperineal resection of the rectum due to rectal carcinoma.

In the period 01.01.1991-12.31.1996, 523 operations due to rectal carcinoma were performed on the First Surgical Clinic, the Third Department for Colorectal Surgery. Most common localization of tumor was in the distal third of the rectum 65.2%. In the middle third, there were 28.9% and in the upper, intraperitoneal third 5.9%. We performed 286 low anterior stapled resections, 93 anterior resections with hand-sewn anastomosis and 144 Abdominoperineal excisions of rectum (Miles procedure). Pathohistological examination revealed adenocarcinoma in all cases. In this study we analyzed local recurrence and five-year survival after long-term follow-up in the group where Miles procedure was carried out as a potentially curative procedure (except 4.9% cased with Dukes D stage). There were 74.3% males and 23.7% females median age 59.2 years. According to Dukes classification there were 4.9% in stage A, 47.2% in stage B, 43.1% stage C, and 4.9% stage D. There were 4(2.7%) postoperative deaths. Recurrence of the disease was registered in 44 (30.5%) patients. Local recurrence alone was found in 14 (9.7%) patients, while distant spread was registered in 30 (20.8%) patients. At present, the median follow-up is at 72.9 months. Analysis by the Kaplan-Meier's test shows cumulative survival of 61%, and disease free survival of 63.4% at 60 months of the follow-up. Dukes C is associated with a very poor prognosis; survival after 60 months of follow up shows cumulative Survival of 0.35 while Dukes B has far better prognosis (0.86). Analysis of disease free survival by Dukes stage shows that Dukes C has the worst prognosis (disease free survival 0.36 after 60 months), while stage B has much better prognosis (0.84). Local recurrence analysis by the Kaplan-Meier's test shows disease free survival of 84.9% at 60 months of follow-up. Analysis of local recurrence by Dukes stage shows 1.00% disease free survival for cases in stage A, 0.94 for Dukes B and 0.66 for Dukes C, while overall comparison between groups regarding local recurrence using the Wilcoxon (Gehan) statistic shows statistically significant difference (p-0.005). There is no statistical difference between Dukes A and Dukes B cases in distribution of local recurrence.

Adenocarcinoma↗
PubMed2000

[Idiopathic inflammatory bowel disease].

IBD (Crohn's disease, ulcerative colitis) present a great challenge to medical sciences because of many secrets which still hidden their real nature. Modern sophisticated digestive surgery occupies very important place in the treatment of IBD, owing to bravurous surgical skill and in a great dill to logistic support of different medical disciplines. Historical evaluation of scientific knowledge and pathways of therapeutic approaches are described. Contemporary principles and method of treatment are particularly stressed, especially on the surgical field.

Digestive System Surgical Procedures↗
PubMed1989

[Early postoperative complications in elective splenectomy in hematologic diseases].

This study analyses frequency of complications and mortality after elective splenectomy done for various hematological diseases, dependent on the spleen weight. From 1979 to 1988 year, 236 patients were treated by splenectomy for various haematological disorders, including: autoimmune disorders (90), Hodgkin's disease (34), lymphoproliferative diseases (96) and myeloproliferative diseases (16 patients). In the early postoperative period, complications occurred in 51 (21.61%) patients, 10 of which (4.24%) died. Considering the size of the spleen (more or less than 1500 gr) there was no difference in the early postoperative mortality (p greater than 0.05; 3.30%:5.38%), while postoperative complications occurred significantly more often in patients with massive splenomegaly (p greater than 0.05; 1259%:3548%). The most frequent complications were septical (8.90%), prolonged fever (5.51 x), and postoperative bleeding (2.97%), while cardial, pulmonary and urinary complications occurred seldom, but more often caused patient's death. Defining the appropriate indications for splenectomy, performing suitable preoperative preparations and postoperative care, mortality was diminished from 7.14% in the period, 1979-1983 year, to 2.17% in the period 1984-1988.

Adolescent↗
PubMed1978

[Traumatic aneurysms].

Analysis of 37 surgical treated patients suffered from traumatic arterial aneurysms and fistulas is done. 27 aneurysms and 10 fistulas is presented. Restoration of continuity of damaged artery was performed in 26 patients and ligation was done in 11 patients. Good long term results were obtained in 29 patients (78.38 per cent), satisfactory in 4 patients and unsatisfactory in four, too. The authors advocate early surgery and method of restoration applied because of they give the best functional results. Ligation of vessel is method of necessity. No mortality and no amputation was in presented serie.

Adolescent↗