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  1. Article: Ultrasonographic evaluation of visceral and subcutaneous abdominal fat tissue before and after bariatric surgery.

    Djurić-Stefanović, A / Vasin, D / Jovanović, S / Lazić, Lj / Kovac, J / Popović, I / Bajec, Dj / Saranović, Dj

    Acta chirurgica Iugoslavica

    2014  Volume 60, Issue 3, Page(s) 25–30

    Abstract: Visceral fat is considered a key factor in the development of metabolic syndrome and other pathological conditions and diseases associated with obesity. Therefore, analysis of the dynamics of reducing the amount of abdominal visceral fat is important for ...

    Abstract Visceral fat is considered a key factor in the development of metabolic syndrome and other pathological conditions and diseases associated with obesity. Therefore, analysis of the dynamics of reducing the amount of abdominal visceral fat is important for evaluating the therapeutic effects of different modalities of obesity treatment, including bariatric surgery. In 53 obese patients visceral and subcutaneous abdominal adipose tissue was measured by ultrasonography (US) before and after bariatric surgery, in the period of 1, 3, 6 months. At the same time, standard anthropometric parameters were assessed: body mass (m), BMI, waist circumference (WC), and hip circumference (HC). Five diameters of the visceral abdominal fat (VAF) were measured: IAFT (Intraabdominal Fat Thickness), LV (Lienal Vein), VF (Visceral Fat), MES sum (Mesenterial leafs) and Max PFT (Maximal Preperitoneal Fat Thickness), and three diameters of the subcutaneous abdominal adipose tissue (SCAF): Min SFT (Minimal Subcutaneous Fat), and MaxSFTa and MaxSFTb (Maximal Subcutaneous Fat Thickness a and b). Statistically significant decrease in all anthropometric parameters, except HC was registered 1, 3 and 6 months after the surgery. We registered the decline of almost all US diameters of abdominal adipose tissue in the follow-up period, but statistically significant decrease were found only in the diameters of visceral adipose tissue: IAFT after 1 and 3 months (p = 0.031 and p = 0.027); VF after 1 month (p = 0.031), LV after 6 months (p = 0.011), and MESsum after 3 and 6 months (p = 0.001 and p = 0.028), as well as MaxSFTb, at 1 month follow-up (p = 0.015). In the short-term follow-up period after the bariatric surgery, there was a significant decrease in body mass, BMI and WC, and ultrasonography revealed a significant reduction in the diameters of the visceral abdominal fat.
    MeSH term(s) Abdominal Fat/diagnostic imaging ; Adult ; Anthropometry ; Bariatric Surgery ; Body Mass Index ; Female ; Follow-Up Studies ; Humans ; Intra-Abdominal Fat/diagnostic imaging ; Male ; Middle Aged ; Obesity/diagnostic imaging ; Obesity/surgery ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult
    Language English
    Publishing date 2014-03-25
    Publishing country Serbia
    Document type Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci1303025d
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  2. Article: Oncology treatment improvement--our experience in Serbia.

    Bozanović, T / Zizić, V / Apostolović, M / Vidaković, S / Aksam, S / Bosković, V / Bajec, Dj / Kotlica, B K

    European journal of gynaecological oncology

    2012  Volume 32, Issue 6, Page(s) 665–666

    Abstract: Objectives: To determine weather structural changes by a tumor board made any difference in quality of treatment for oncology patients.: Material and method: Current management of our hospital initiated structural changes in the tumor board in ... ...

    Abstract Objectives: To determine weather structural changes by a tumor board made any difference in quality of treatment for oncology patients.
    Material and method: Current management of our hospital initiated structural changes in the tumor board in January 2010 and improvement was measured through comparing the clinical staging of cervical cancer to previous tumor board results.
    Results: 365 patients were seen by a multidisciplinary tumor board from January to December of 2010. There were 146 cases of cervical cancer. 87 were staged as Ib-IIa for radical surgery, 59 patients were staged as advanced stage of disease and RT was proposed as well as combined radio-chemotherapy in some cases.
    Conclusion: Structural changes in the tumor board have made a significant improvement in the oncology care of our patients, primarily because of a multidisciplinary approach to gynecological malignancies and additional imaging performed in all cases of cervical cancer for better insight in the spread of the disease.
    MeSH term(s) Combined Modality Therapy ; Female ; Genital Neoplasms, Female/pathology ; Genital Neoplasms, Female/therapy ; Humans ; Neoplasm Staging ; Serbia
    Language English
    Publishing date 2012-02-03
    Publishing country China
    Document type Journal Article
    ZDB-ID 604589-3
    ISSN 0392-2936
    ISSN 0392-2936
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  3. Article: Povrede slezine i mortalitet u politraumi.

    Sijacki, A / Gregorić, P / Bajec, Dj / Atanasijević, T / Radibratović, S

    Acta chirurgica Iugoslavica

    2003  Volume 49, Issue 3, Page(s) 63–65

    Abstract: Severe trauma is the leading cause of death in the working population. Traffic accidents are the most frequent etiological factor, with substantially more male than female victims. In this paper we have analyzed 53 cases of dead patients, among 240 ... ...

    Title translation Splenic injuries and mortality in polytrauma.
    Abstract Severe trauma is the leading cause of death in the working population. Traffic accidents are the most frequent etiological factor, with substantially more male than female victims. In this paper we have analyzed 53 cases of dead patients, among 240 severe traumatized treated in Center of emergency surgery, Emergency Center, CCS from January, 2000-June 2002. Spleen is the most frequent injured abdominal organ. In 34% surviving period was less than 72 hours. One-third of patients required at least two surgeries, including laparotomy. The most preciously diagnosis were performed in the cases of spleen injuries. The most common cause of death was cariopulmonal insufficiency, according both clinical diagnosis and forensic findings.
    MeSH term(s) Abdominal Injuries/diagnosis ; Abdominal Injuries/mortality ; Adolescent ; Adult ; Aged ; Child ; Humans ; Middle Aged ; Multiple Trauma/diagnosis ; Multiple Trauma/mortality ; Spleen/injuries ; Survival Rate
    Language Croatian
    Publishing date 2003-01-30
    Publishing country Serbia
    Document type English Abstract ; Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci0203063s
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  4. Article: [Postoperative use of nonsteroidal anti-inflammatory agents in orthopedic surgery].

    Popović, N M / Karamarković, A R / Blagojević, Z B / Terzić, B V / Nikolić, V T / Gregorić, P B / Djoković, J / Bajec, Dj D

    Acta chirurgica Iugoslavica

    2010  Volume 57, Issue 1, Page(s) 85–92

    Abstract: Nonsteroidal antiinflamatory drugs (NSAIDs) lead to satisfactory acute and chronic pain relief. Besides that, they exert potent antiinflamatory effect. Their analgesic potency is dose related and limited. Orthopedic patients are often on these ... ...

    Abstract Nonsteroidal antiinflamatory drugs (NSAIDs) lead to satisfactory acute and chronic pain relief. Besides that, they exert potent antiinflamatory effect. Their analgesic potency is dose related and limited. Orthopedic patients are often on these medications preoperatively and experience opioid-sparing effect in the postoperative period. Chronic NSAIDs use is related to higher rate of sistemic adverse effects, but even short time exposure in the postoperative period is not risk-free. Although Coxibs reduce GIT bleeding incidence due to prolonged use of NSAIDs, there has to be judicious decision considering their cardiovascular adverse effects. There is evidence that NSAIDs producing moderate, dose-dependent increased bleeding time within normal values. High risk of bleeding have patients with established coagulopathy, alcohol abuse and on anticoagulant treatment. There is no strong evidence on influence of NSAIDs on bone growth. Nevertheless, there is evidence that NSAIDs do prevent heterotropic ossification. Prostaglandins are vital contributors for maintainig tissue homeostasis and NSAIDs use can lead to many unwanted effects. Those adverse effect are more common with prolonged exposure, are dose-related and risks have to be carefully and individually assesed in the postoperative pain management.
    MeSH term(s) Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Humans ; Orthopedic Procedures ; Pain, Postoperative/drug therapy
    Chemical Substances Anti-Inflammatory Agents, Non-Steroidal
    Language Serbian
    Publishing date 2010-07-28
    Publishing country Serbia
    Document type English Abstract ; Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci1001085p
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  5. Article: Prednosti i nedostaci planiranih etapnih relaparotomija "ziper tehnikom" kod hirurskog lecenja nekroticnog pankreatitisa.

    Radenković, D / Bajec, Dj / Karamarković, A / Stefanović, B / Gregorić, P / Milićević, M

    Acta chirurgica Iugoslavica

    2004  Volume 50, Issue 2, Page(s) 99–103

    Abstract: The rationale of surgical intervention during acute necrotizing pancreatitis is to remove necrotic tissue preserving healthy glandular parenchyma and other adjacent structures, thus limiting severe complications. Necrosectomy and debridement are the ... ...

    Title translation Advantages and disadvantages of planned staged relaparotomy using the zipper technique in surgical treatment of necrotizing pancreatitis.
    Abstract The rationale of surgical intervention during acute necrotizing pancreatitis is to remove necrotic tissue preserving healthy glandular parenchyma and other adjacent structures, thus limiting severe complications. Necrosectomy and debridement are the crucial in surgical management, further treatment of pancreatic bed and peripancreatic tissue are still a matter of debate among pancreatic surgeons. Zipper technique is one of the three recognized methods [table: see text] for the surgical management of necrotizing pancreatitis. The aim this study was to review the literature data about treatment using this technique, as well to compare the results of treatment with other techniques, in order to present the advantage and disadvantage of zipper technique. The main advantage of this technique is a high level of control of intraabdominal infection and other septic complications associated with necrotizing pancreatitis and its surgical management. Increased risk of development of gastrointestinal and pancreatic fistulas as well of intraabdominal bleeding is probably the main disadvantage. A flexible approach focused on the individual patients is a reasonable solution in the surgical management of the necrotizing pancreatitis.
    MeSH term(s) Humans ; Laparotomy/adverse effects ; Laparotomy/methods ; Pancreatitis, Acute Necrotizing/surgery ; Postoperative Complications ; Reoperation
    Language Croatian
    Publishing date 2004-01-01
    Publishing country Serbia
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci0302099r
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  6. Article: [Orthopedic injuries in polytrauma].

    Popović, N / Blagojević, Z / Nikolić, V / Stefanović, B / Bajec, Dj / Karamarković, A / Vujadinović, D / Pavlović, A

    Acta chirurgica Iugoslavica

    2007  Volume 53, Issue 4, Page(s) 85–88

    Abstract: Trauma is one of the leading causes of mortality in the world. Traumatic injury has a significant impact on the patient, socially, functionally and financially. Orthopaedic injuries are generally not life-threatening unless they result in significant ... ...

    Abstract Trauma is one of the leading causes of mortality in the world. Traumatic injury has a significant impact on the patient, socially, functionally and financially. Orthopaedic injuries are generally not life-threatening unless they result in significant hemodynamic instability. The outcome of the orthopaedic injuries might lead to mild or severe disability and lost quality of life. Therefore, the orthopaedic surgeon has significant role in treatment of trauma patient. In order to control and prevent traumatic injuries, to improve quality of trauma treatment and outcome, including the costs the National trauma registry is essential. The aim of the study was to collect the datas about the frequency of orthopaedic injuries in polytraumatised patients who were treated in intensive care unit of Emergency Center of Serbia in last two years. There were significant number of orthopaedic injuries (53.2%) in polytraumatised patients. The major cause of the injuries is traffic (78.6%) and most patients were between 30-50 years (30%).
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Female ; Fractures, Bone/therapy ; Humans ; Male ; Middle Aged ; Multiple Trauma/pathology
    Language Serbian
    Publishing date 2007-08-04
    Publishing country Serbia
    Document type English Abstract ; Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci0604085p
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  7. Article: [Damage control surgery in abdominal trauma].

    Karamarković, A R / Popović, N M / Blagojević, Z B / Nikolić, V T / Gregorić, P B / Bukurov, M N / Djukić, V R / Bajec, Dj D

    Acta chirurgica Iugoslavica

    2010  Volume 57, Issue 1, Page(s) 15–24

    Abstract: The damage control laparotomy is an advancement in the management of massively injured trauma patients. Massive liver injuries, pelvic trauma and some retroperitoneal injuries are some of the indications for this approach. The damage control laparotomy ... ...

    Abstract The damage control laparotomy is an advancement in the management of massively injured trauma patients. Massive liver injuries, pelvic trauma and some retroperitoneal injuries are some of the indications for this approach. The damage control laparotomy is the phased approach to severe abdominal injury that might best be described with the acronym STIR (Staged Trauma Injury Repair). The initial procedure requires rapid abdominal exploration with hemorrhage and contamination control, using suture repair combined with abdominal packing. Temporary abdominal wall closure without tension is recommended. After abrevated initial surgical procedure, the patient is transferred to the intensive care unit where continued resuscitation is performed. Careful replacement of blood and blood products along with correction of hypothermia, acidosis and optimalization of oxygen transport represents a critical phase in this management approach. Once the coagulation profile has normalized, planned re-intervention, with repeat abdominal exploration to remove the packs and perform definitive surgical repair and reconstruction takes place. When applied judiciously, the damage control laparotomy with the staged abdominal repair and reconstruction for severe trauma is associated with an improved outcome in the selected group of patients.
    MeSH term(s) Abdominal Injuries/pathology ; Abdominal Injuries/surgery ; Humans ; Laparotomy
    Language Serbian
    Publishing date 2010-07-28
    Publishing country Serbia
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci1001015k
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  8. Article: Protektivna strategija ventilacije u sindromu akutnog respiratornog distresa.

    Bumbasirević, V / Bukumirović, V / Popović, N / Nikolić, V / Kalezić, N / Vlajković, G / Karamarković, A / Sijacki, A / Bajec, Dj / Ranković, Vitomir

    Acta chirurgica Iugoslavica

    2005  Volume 51, Issue 3, Page(s) 45–49

    Abstract: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) contribute to progressive hypoxemia in critically ill patients. It has been proved that conventional mechanical ventilation with physiological respiratory volume contributes to ... ...

    Title translation Protective ventilation strategy in the acute respiratory distress syndrome.
    Abstract Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) contribute to progressive hypoxemia in critically ill patients. It has been proved that conventional mechanical ventilation with physiological respiratory volume contributes to further lung damage. In this respect, application of protective ventilatory strategy--pulmonary ventilation with limited volume and pressure can avoid mentioned consequences. The aim of this paper is to discuss mechanims by which elements contained in protective mechanical ventilation of patients with ALI/ARDS prevent further progrssive lung injury, to argue the effects of positive end--expiratory pressure and present insturctions for its application.
    MeSH term(s) Humans ; Respiration, Artificial/adverse effects ; Respiration, Artificial/methods ; Respiratory Distress Syndrome, Adult/physiopathology ; Respiratory Distress Syndrome, Adult/therapy
    Language Serbian
    Publishing date 2005-03-28
    Publishing country Serbia
    Document type English Abstract ; Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci0403045b
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  9. Article: Intrahepaticna B3 holangiojejunostomija u palijativnom hirurskom tretmanu visokih neresektabilnih malignih bilijarnih opstrukcija.

    Karamarković, A / Milić, N / Djukić, V / Radenković, D / Jeremić, V / Bumbasirević, V / Popović, N / Kojić, Z / Bajec, Dj

    Acta chirurgica Iugoslavica

    2005  Volume 51, Issue 3, Page(s) 85–91

    Abstract: Palliating the effects of biliary obstruction is a major goal of therapy in patients with unresectable cancer at the hepatic duct confluence. We reviewed our expirience with intrahepatic holangioenteric bypass to the segmental bile duct B3 as a ... ...

    Title translation Intrahepatic B3 cholangiojejunostomy in the palliative surgery of high unresectable malignant biliary obstruction.
    Abstract Palliating the effects of biliary obstruction is a major goal of therapy in patients with unresectable cancer at the hepatic duct confluence. We reviewed our expirience with intrahepatic holangioenteric bypass to the segmental bile duct B3 as a palliative therapy in patients with unresectable malignant diseases involving the ductal confluence or the common hepatic duct. Since March 2001, we have performed intrahepatic segmental bile duct B3 cholangiojejunostomy by Roux-en-Y fashion utilizing a round ligament approach in 13 patients with malignant obstructive jaundice due to unresectable hilar holangiocarcinoma (8 cases) and gallbladder cancer (5 cases). Mean hospital stay was 123 days and mean blood loss was 25060 mL. Postoperative complications occurred in 3 patients (23%), but there was no surgical complications such as postoperative bleeding, bile leakage or abscess formation. 30-day mortality was 7.7% (1 patient). Late complications (37.5%) were observed in 3 of the 8 patients who survived for more than 5 months after the surgery. Median survival after B3 cholangiojejunostomy was 9 months (range, 10 days-22 months). Median survival time was significantly greater in patients with hilar cholangio-carcinoma (11.8 months; range: 2-22 months) compared with those with gallbladder cancer (4.6 months; range: 10 days-11.5 months) (P-0.032 log rank test; P-0.049 Tarone-Ware test). Intrahepatic B3 cholangiojejunostomy when combined with careful patient selection, can provide useful palliation from jaundice, pruritus and cholangitis with acceptable mortality and morbidity rates.
    MeSH term(s) Aged ; Anastomosis, Roux-en-Y ; Bile Duct Neoplasms/complications ; Bile Duct Neoplasms/mortality ; Bile Ducts, Intrahepatic/surgery ; Cholangiocarcinoma/complications ; Cholangiocarcinoma/mortality ; Cholestasis/etiology ; Cholestasis/surgery ; Gallbladder Neoplasms/complications ; Gallbladder Neoplasms/mortality ; Hepatic Duct, Common ; Humans ; Jejunum/surgery ; Klatskin Tumor/complications ; Klatskin Tumor/mortality ; Middle Aged ; Palliative Care ; Postoperative Complications ; Survival Rate
    Language Serbian
    Publishing date 2005-03-28
    Publishing country Serbia
    Document type English Abstract ; Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci0403085k
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  10. Article: [Total gastrectomy in the surgical treatment of acute massive hemorrhage caused by Dieulafoy lesion of the gastric fundus].

    Karamarković, A R / Gregoric, P B / Popović, N M / Ivancević, N N / Bumbasirević, V M / Sijacki, A M / Lausević, Z / Bajec, Dj D / Djukić, V R / Jeremić, V M

    Acta chirurgica Iugoslavica

    2007  Volume 54, Issue 1, Page(s) 173–176

    Abstract: GI bleeding caused by Dieulafoy lesion in the gastric fundus: a case report Dieulafoy lesion is a rare cause of massive gastrointestinal (GI) hemorrhage that can be fatal. It arises from an abnormally large eroded submucosal artery and in more than 75% ... ...

    Abstract GI bleeding caused by Dieulafoy lesion in the gastric fundus: a case report Dieulafoy lesion is a rare cause of massive gastrointestinal (GI) hemorrhage that can be fatal. It arises from an abnormally large eroded submucosal artery and in more than 75% of cases the lesion is mostly found within 6 cm of the cardia. The severity of bleeding and the site of the lesion render the diagnosis sometimes difficult, more than one endoscopic exam is often required. Surgery was regarded as the treatment of choice in the past, but recently endoscopic management has become the standard approach. We report a case of an 42-year-old man presented with upper GI hemorrhage. Repeated upper GI endoscopies revealed a missed diagnosis of subcardial gastric ulcer and Mallory-Weis lesion. Following conservative treatment, the frequency and amount of haemorrhage decreased and totally stop. 48 hours after admission patient developed sudden massive upper GI bleeding and underwent emergency total gastrectomy. The diagnosis of Dieulafoy lesion was made histologically. The patient recovered uneventfully and discharged on the postoperative day 11th. Therefore, Dieulafoy disease represent a diagnostic and therapeutic challenge. Advances in endoscopic technique have greatly assisted in earlier diagnosis and added options to the treatment regimen for this lesion. The relationship of this anomaly to possible exsanguination makes it essential that both endosopical and surgical approach play an important role in the management of this pathology.
    MeSH term(s) Adult ; Arteriovenous Malformations/complications ; Arteriovenous Malformations/diagnosis ; Arteriovenous Malformations/surgery ; Diagnosis, Differential ; Gastrectomy ; Gastric Fundus/blood supply ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/surgery ; Humans ; Male
    Language Serbian
    Publishing date 2007-07-03
    Publishing country Serbia
    Document type Case Reports ; English Abstract ; Journal Article
    ZDB-ID 428721-6
    ISSN 0354-950X ; 0001-5474
    ISSN 0354-950X ; 0001-5474
    DOI 10.2298/aci0701173k
    Database MEDical Literature Analysis and Retrieval System OnLINE

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