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Mile Ignjatović

Publications and source records attributed to Mile Ignjatović.

At least 19 recordsLinked to original sources
PubMed2006

[Early complications following radical surgical treatment of patients with gastric adenocarcinoma].

BACKGROUND/AIM: Surgical treatment of patients with gastric adenocarcinoma means the total excision of a tumor and the pathways of its spreading with the risk of operational complications as low as possible. The aim of this study was to evaluate the type and frequency of early postoperative complications and mortality after a radical surgical treatment of patients with gastric adenocarcinoma. METHODS: Complication rates and postoperative mortality were studied in 70 consecutive patients in whom a radical surgical procedure, gastrectomy (total or subtotal) with D2 lymphadenectomy, was performed. In the early postoperative period, the frequencies of general and specific complications were detected. The frequencies of complications were compared between the groups of patients according to the defined clinical, operative and pathohistological paramethers. RESULTS: The overall morbidity and mortality rates were 27.14% and 5.71%, respectively Pancreatic fistula in five, and pleural effusion in three patients were the most frequently registered complications. Three of four deaths occured in patients older than 70 years, with the stage III and IV of the disease, and in all of them total gastrectomy with splenectomy was performed. A statistically significant difference (p < 0.05) in complication rates was found between the groups of patients with and without splenectomy and with the tumors > 5 cm and < or = 5 cm. CONCLUSION: Radical surgical treatment of patients with gastric adenocarcinoma might be done with an acceptable morbidity and mortality if it is performed by the surgeons with the experience in D2 lymphadenectomy technique. A diameter of the tumor > 5 cm, and splenectomy, and/or splenopancreatectomy are the most important risk factors for the occurrence of complications and modifications of D2 lymphadenectomy technique with limited indications for splenic and/or pancreas resection can improve treatment results. An individual approach and the appropriate selection of the surgical procedure are necessary in patients older than 70 years.

Adenocarcinoma↗
PubMed2006

[Detection of free cancer cells in peritoneal cavity in patients surgically treated for gastric adenocarcinoma].

BACKGROUND/AIM: Peritoneal metastasis is a leading cause of therapeutic failure after an operative treatment of patients with gastric adenocarcinoma. Free cancer cells might induce or indicate an early peritoneal seeding with a subsequent peritoneal metastasis. The aim of this study was to determine the frequency of the presence of free cancer cells in the peritoneal cavity in the patients surgically treated for gastric adenocarcinoma, and its relation to certain clinical, operative and pathohistological paramethers. METHODS: Inside a period from April 2000, and April 2004, the total of 100 patients underwent intraoperative peritoneal lavage for cytological examination. Immediately after the laparotomy, 200 ml physiologic saline, heated to 37 degrees C, was introduced into the abdominal cavity, mannualy dispersed and collected from the region around the gastric tumor and the pouch of Douglas. The nucleated cell layer was smeared on four glass slides for every patient and dyed with May-Grünwald-Giemsa stain. The cytological findings were defined as positive or negative according to the presence of cancer cells. The frequency of positive cytological findings was compared to the location and the diameter of the cancer, pathohistological type of carcinoma, pathohistological stage of the disease, lymph node and the liver and/or peritoneal metastases and the type of surgical procedure. RESULTS: Free cancer cells were found in 24 (24%) of the patients, while in 76 (76%) of them cytological findings were negative. A statistically highly significant difference (p < or = 0.001) in the frequency of positive cytological finding was found between the groups of patients with and without cancer invasion of serosa, with cancer diameters > 5 cm and < or = 5 cm, in the stage of disease I, II and III, IV, with macroscopically present and without metastases, with re section and D2 lymphadenectomy and palliative procedure. Free cancer cells were statistically more frequently (p < or = 0.05) detected in the patients with lymph nodes metastases comparing to the patients with out lymph nodes involvement. The results of the univariate analysis showed that the cancer diameter > 5 cm, tumor invasion of serosa, pathohistological stage of the disease III and IV and macroscopically visible metastases were the most important risk factors for the free cancer cells detection. CONCLUSION: Peritoneal lavage cytology was shown to be a useful tool for the detection of the group of patients with greatest risk of peritoneal dissemination. The frequency of positive cytological findings was highly associated with the diameter of the tumor and the cancer invasion of serosa. Cytological examination of peritoneal lavage fluid improved the accuracy of staging and selection of patients who might have benefit from neoadjuvant chemotherapy.

Adenocarcinoma↗
PubMed2006

[Salerno].

Explore the source record for details and available documents.

History of Medicine↗
PubMed2006

[Indirect blast rupture of the pancreas with a primary unperforated blast injury of the duodenum].

BACKGROUND: To present a patient with an indirect blast rupture of the head of pancreas, as well as with a blast contusion of the duodenum following abdominal gunshot injury. CASE REPORT: A patient with the abdominal gunshot injury was submitted to the management of the injury of the liver, gaster and the right kidney in the field hospital. The revealed rupture of the head of the pancreas and the contusion of the duodenum were managed applying the method of Whipple. CONCLUSION: Indirect blast injuries require extensive surgical interventions, especially under war conditions.

Abdominal Injuries↗
PubMed2005

Liver hydatid disease: morphological changes of protoscoleces after albendazole therapy.

BACKGROUND: Postoperative recurrence of the liver hydatid disease befalls approximately 10-30% of patients. Preoperative or postoperative therapy with albendazole in single therapeutic protocol (800 mg/d, within 28 days) indicated the need to evaluate the hydatid cyst liquid protoscoleces viability. Morphological changes of protoscoleces following the treatment with drugs are not well known. AIM: To estimate the viability of protoscoleces after preoperative or postoperative albendazole therapy, and their ability for cystic metamorphosis. METHODS: A prospective, randomized clinical trial included 30 patients with liver hydatid disease, treated with albendazole and surgically (I group), and 30 patients in the control group treated only surgically (II group). The concentration of albendazole and its active metabolite albendazole sulphoxide in the cysts contents were determined using HPLC. Estimation of protoscoleces viability was based on the established micromorphologic criteria, and compared between the patients treated with albendazole, and the patients treated only surgically. Biological assessment of the viability was performed on protoscoleces with uncertain signs of the disturbed viability (unchanged structure, evaginated, without movements) using intraperitoneal injection of 1 ml of protoscoleces prepared suspension to AO type of rats. RESULTS: The concentration of albendazole in cysts' contents ranged from 0 to 64.9 microg/ml, and of its active metabolite from 0.5 to 40.8 microg/ml. The presence of fully viabile protoscoleces in the albendazol treated patients was significantly lower than in the control group. A significant difference was noticed in the presence of disintegrated protoscoleces without movements in the albendazol treated group, compared to the control group. Biological assessment of the viability showed incapability of these protoscoleces for cystic metamorphoses. CONCLUSION: Low viability of parasites due to medicamentous therapy is very useful and important to surgeons, because the fertility of cysts is lower, and the risk of the disease recurrence is reduced.

Albendazole↗
PubMedDate not supplied

[Menetrier's disease associated with ulcerative colitis].

In this paper a 21 year old patient was presented with Ménétrier's disease, associated with ulcerative colitis. The first symptoms of ulcerative colitis occurred at the age of eleven, since when the patient has been conservatively treated several times because of the exacerbations of the disease. During control examinations presence of polyploid changes in stomach was discovered by upper endoscopy. Gastrectomy was suggested because the patient had excessive anemic syndrome which required weekly substitutional therapy with deplasmatic eritrocytes, as well as hypoproteinemia, while multiple polyploid changes suspect for malignancy were gastroscopically identified. Patient accepted surgical treatment, and was transferred to the Clinic of Surgery. Total gastrectomy was performed, and patohistological finding confirmed Ménétrier's disease. After two weeks, the patient was released from the hospital in good general condition, with regular clinical and laboratory findings.

Adult↗
PubMedDate not supplied

[Gastrointestinal stromal tumors].

BACKGROUND: Gastrointestinal Stromal Tumors (GISTs) are non-epithelial, non-myogenic, non-neurogenic, and non-lymphogenic GIT neoplasms built of spindle and/or epithelioid cells with the expression of c-kit proteins. Histogenesis is still unclear, criteria of malignancies are not adopted, biological behavior is not known, and the diagnosis and prognosis are questionable. The aim of the paper was to create clearer conclusions about the diagnosis, prognosis and treatment of GIST, upon the analysis of numerous cases. METHODS: On the basis of multifaceted search of Medline, Index Medicus and cited references, published articles were collected, in all languages, from the first published case in 1984 until the end of 2000. The analysis of 98% published articles with 2088 (99%) GIST cases was performed. After quantitative synthesis, qualitative analysis was obtained by statistical data processing. RESULTS: GISTs were represented in 1-4% of gastrointestinal tract (GIT) tumors, and they were most frequently (42%) nonepithelial GIT tumors. GIST (n = 1368) were most frequently located on the stomach (53%) then on the small intestine (27%), rectum (4%) and on the colon, duodenum, esophagus, retroperitoneum, mesenterium and omentum (2-3%). Histopathologic, imunohistochemical, and prognostic differences were significantly dependent on GIST localization. GIST (n = 1040) were equally present in males and females, but GIST of the small intestine was more frequently found in females. The average age of patients was 62 years. Symptomatology of GIST was nonspecific and one third of patients were asymptomatic. Imuno-histochemical investigations (n = 1492) were necessary for the correct GIST diagnosis, and they were positive on: vimentin in 98%, CD117 in 90%, CD34 in 65%, NSE in 58%, S-100 in 21%, SMA in 33% and desmin in 8% of cases. About 55% of GIST had malignant behavior. At the moment of operative treatment, 20% of patients had liver and/or peritoneal metastases. Metastatic dissemination of GIST was not lymphatic. Prognosis of malignant GIST was significantly poorer compared to the other GIT sarcomas. The most significant clinical parameters of the disease behavior were tumor size and mitotic activity, and significant were: tumor localization, hemorrhage and necrosis in the tumor, cellularity, mucosal invasion, and cellular and nuclear atypia. In spite of all criteria, even the most benign GIST could relapse with metastases. Even the incomplete resection as well as the resection of recurrent tumor had enabled better survival rate. CONCLUSIONS: According to this analysis GIST were the most frequent stromal GIT tumors. Correct diagnosis of GIST was based on imunohistochemical studies, and biological behavior upon the clinico-pathological parameters in 90% of cases. Complete surgical resection was the only therapeutic option. Regional lymphadenectomy was not necessary. Long-term follow-up of these patients was necessary due to the high incidence of recurrence.

Gastrointestinal Neoplasms↗