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  1. Article ; Online: The combination of the three modifications of the component separation technique in the management of complex subcostal abdominal wall hernia.

    Zuvela, M / Galun, D / Bogdanovic, A / Loncar, Z / Zivanovic, M

    Hernia : the journal of hernias and abdominal wall surgery

    2022  Volume 26, Issue 5, Page(s) 1369–1379

    Abstract: Purpose: The purpose of this study is to present a concept combining three modifications of the component separation technique (CST) in one procedure as an original solution for the management of complex subcostal abdominal wall hernia.: Methods: ... ...

    Abstract Purpose: The purpose of this study is to present a concept combining three modifications of the component separation technique (CST) in one procedure as an original solution for the management of complex subcostal abdominal wall hernia.
    Methods: Between January 2010 and January 2020, seven patients presenting at the high-volume academic center with complex subcostal hernia underwent surgery in which three modifications of CST were combined into one procedure. Major complex subcostal hernia was defined by either width or length of the defect being greater than 10 cm. The following were the stages of the operative technique: (a) the "method of wide myofascial release" at the side of the hernia defect; (b) "open-book variation" of the component separation technique at the opposite side of the hernia defect; (c) a modified component separation technique for closure of midline abdominal wall hernias in the presence of enterostomies; (d) suturing of the myofascial flaps to each other to cover the defect; and (e) repair augmentation with an absorbable mesh in the onlay position.
    Results: The median length and width of the complex subcostal hernias were 15 cm (10-19) and 15 cm (8-24), respectively. The overall morbidity rate was 57.1% (wound infection occurred in three patients, seroma in two patients, and skin necrosis in one patient). There was no hernia recurrence during the median follow-up period of 19 months.
    Conclusion: The operative technique integrating three modifications of CST in one procedure with onlay absorbable mesh reinforcement is a feasible solution for the management of complex subcostal abdominal wall hernia.
    MeSH term(s) Abdominal Wall/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods ; Humans ; Recurrence ; Seroma ; Surgical Flaps ; Surgical Mesh
    Language English
    Publishing date 2022-05-16
    Publishing country France
    Document type Journal Article
    ZDB-ID 1388125-5
    ISSN 1248-9204 ; 1265-4906
    ISSN (online) 1248-9204
    ISSN 1265-4906
    DOI 10.1007/s10029-022-02622-w
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  2. Article ; Online: Liver resection versus transarterial chemoembolization for huge hepatocellular carcinoma: a propensity score matched analysis.

    Bogdanovic, A / Bulajic, P / Masulovic, D / Bidzic, N / Zivanovic, M / Galun, D

    Scientific reports

    2021  Volume 11, Issue 1, Page(s) 4493

    Abstract: To date, it is unclear which treatment modality, liver resection (LR) or transarterial chemoembolization (TACE) is the more appropriate for patients with huge (≥ 10 cm) hepatocellular carcinoma (HCC). The study aim was to compare, using propensity score ... ...

    Abstract To date, it is unclear which treatment modality, liver resection (LR) or transarterial chemoembolization (TACE) is the more appropriate for patients with huge (≥ 10 cm) hepatocellular carcinoma (HCC). The study aim was to compare, using propensity score matching, short- and long-term outcomes of patients with huge HCC who underwent potentially curative LR or TACE. Patients with huge HCC who had been managed at the Clinical Center by curative-intent LR or by palliative TACE between November 2001 and December 2018 were retrospectively identified. The morbidity and mortality rates and overall survival were compared between the groups before and after the propensity score matching. Independent predictors of long-term survival were determined by multivariate analysis. A total of 103 patients with huge HCC were included; 68 were assigned to the LR group and 35 to the TACE group. The overall morbidity rate was higher in the LR group than in the TACE group before matching (64.7% vs. 37.1%, p = 0.012), while there was no difference after matching (60% vs. 30%, p = 0.055). The major morbidity and 30-days mortality were similar between the groups before and after matching. The LR group was associated with longer overall survival than the TACE group before matching (p = 0.032) and after matching (p = 0.023). Total bilirubin and TACE treatment were independent prognostic factors associated with long-term survival. In patients with huge HCC, liver resection provides better long-term survival than TACE and should be considered as the initial treatment whenever possible.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/pathology ; Chemoembolization, Therapeutic/methods ; Female ; Hepatectomy/methods ; Humans ; Liver/pathology ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Propensity Score ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2021-02-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-021-83868-9
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  3. Article ; Online: Management of epigastric, umbilical, spigelian and small incisional hernia as a day case procedure: results of long-term follow-up after open preperitoneal flat mesh technique.

    Zuvela, M / Galun, D / Bogdanovic, A / Bidzic, N / Zivanovic, M

    Hernia : the journal of hernias and abdominal wall surgery

    2021  Volume 25, Issue 4, Page(s) 1095–1101

    Abstract: Purpose: To investigate short and long-term outcome after the open preperitoneal flat mesh technique (OPFMT) for umbilical, epigastric, spigelian, small incisional and "port-site" hernia performed as a day case procedure.: Methods: We retrospectively ...

    Abstract Purpose: To investigate short and long-term outcome after the open preperitoneal flat mesh technique (OPFMT) for umbilical, epigastric, spigelian, small incisional and "port-site" hernia performed as a day case procedure.
    Methods: We retrospectively analyzed records of patients who underwent OPFMT for umbilical, epigastric, Spigelian, small incisional and "port-site" hernia in ambulatory settings between 2004 and 2020 at Clinical Center of Serbia. Demographic and clinical characteristics, operative data and postoperative complications were compared between the groups. Univariate and multivariate analyses were performed to identify predictive factors for mesh infection and recurrence.
    Results: Overall, 476 patients were divided according to the type of hernia. Early postoperative complications were similar in all study groups. Mesh infection, chronic pain and recurrence were different between groups (p = 0.013, p = 0.019 and p = 0.011, respectively). Overall recurrence rate after OPFMT was 2.5%. Hernia defect, hematoma and length of postoperative stay at the Day Surgery Unit were identified as potential predictors of mesh infection (Odds ratio 6.449, 22.143 and 1.546, respectively; p = 0.027, p = 0.011 and p = 0.038, respectively) while mesh infection was the only potential predictor of recurrence in univariate analysis. Hematoma was an independent predictor of recurrence (Odds ratio 27.068; 95% Confidence interval 2.355-311.073; p = 0.008).
    Conclusion: The OPFMT performed under local anesthesia as a day case procedure is a safe technique associated with favorable long-term outcome. Hematoma is an independent predictor of mesh infection occurrence.
    MeSH term(s) Follow-Up Studies ; Hernia, Umbilical/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Humans ; Incisional Hernia/etiology ; Incisional Hernia/surgery ; Recurrence ; Retrospective Studies ; Surgical Mesh/adverse effects
    Language English
    Publishing date 2021-06-24
    Publishing country France
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1388125-5
    ISSN 1248-9204 ; 1265-4906
    ISSN (online) 1248-9204
    ISSN 1265-4906
    DOI 10.1007/s10029-021-02446-0
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  4. Article: Short- and Long-Term Outcomes After Hepatectomy in Elderly Patients with Hepatocellular Carcinoma: An Analysis of 229 Cases from a Developing Country.

    Galun, Danijel / Bogdanovic, Aleksandar / Zivanovic, Marko / Zuvela, Marinko

    Journal of hepatocellular carcinoma

    2021  Volume 8, Page(s) 155–165

    Abstract: Background: The number of elderly patients with HCC who undergo liver resection is increasing. Because of the advanced age of the patients, increased postoperative morbidity and reduced overall survival are expected in this population. The study aim was ...

    Abstract Background: The number of elderly patients with HCC who undergo liver resection is increasing. Because of the advanced age of the patients, increased postoperative morbidity and reduced overall survival are expected in this population. The study aim was to compare clinicopathologic and operative features, short- and long-term outcomes among hepatocellular carcinoma (HCC) patients from three age groups undergoing potentially curative liver resection in a developing country.
    Methods: Prospectively collected data relating to 229 patients who underwent curative-intent liver resection from January 2009 until December 2018 were analyzed. The patients were divided into two age groups: G1 was below 70 years old (n=151) and G2 was 70 years old and older (n=78). Demographic, clinical, operative data, short- and long-term outcomes were compared between the two groups. Univariate and multivariate analyses of prognostic factors were performed.
    Results: The mean overall morbidity rate of the patients was 31.1% (G1), and 46.2% (G2) by age group. Postoperative morbidity was significantly higher in the G2 group (p=0.03). There was no difference in major morbidity between the two groups (p=0.214). No significant difference in mortality rate and overall survival was found between the study groups (p=0.280, p=0.383). Both age ≥70 years (ie, G2 group) and liver cirrhosis were identified as prognostic factors for postoperative morbidity, and a Child-Pugh score B as a negative prognostic factor for overall survival. In subgroup analysis of patients with cirrhosis, age ≥70, diabetes mellitus and perioperative transfusion were identified as prognostic factors for postoperative morbidity.
    Conclusion: The study confirmed the safety and feasibility of liver resection in elderly patients with HCC. However, appropriate patient selection among the elderly is mandatory in order to improve short- and long-term outcomes.
    Language English
    Publishing date 2021-03-23
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2780784-8
    ISSN 2253-5969
    ISSN 2253-5969
    DOI 10.2147/JHC.S297296
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  5. Article: Precision Medicine for Hepatocellular Carcinoma: Clinical Perspective.

    Galun, Danijel / Mijac, Dragana / Filipovic, Aleksandar / Bogdanovic, Aleksandar / Zivanovic, Marko / Masulovic, Dragan

    Journal of personalized medicine

    2022  Volume 12, Issue 2

    Abstract: Hepatocellular carcinoma (HCC) is one of the major malignant diseases worldwide, characterized by growing incidence and high mortality rates despite apparent improvements in surveillance programs, diagnostic and treatment procedures, molecular therapies, ...

    Abstract Hepatocellular carcinoma (HCC) is one of the major malignant diseases worldwide, characterized by growing incidence and high mortality rates despite apparent improvements in surveillance programs, diagnostic and treatment procedures, molecular therapies, and numerous research initiatives. Most HCCs occur in patients with liver cirrhosis, and the competing mortality risks from the tumor and the cirrhosis should be considered. Presently, previously identified risk factors, such as hepatitis virus infection, hepatic inflammation and fibrosis, and metabolic syndrome, may be used as chemoprevention targets. The application of precision medicine for HCC management challenges the one-size-fits-all concept; moreover, patients should no longer be treated entirely according to the histology of their tumor but based on molecular targets specific to their tumor biology. Next-generation sequencing emphasizes HCC molecular heterogeneity and aids our comprehension of possible vulnerabilities that can be exploited. Moreover, genetic sequencing as part of a precision medicine concept may work as a promising tool for postoperative cancer monitoring. The use of genetic and epigenetic markers to identify therapeutic vulnerability could change the diagnosis and treatment of HCC, which so far was based on Barcelona clinic liver cancer (BCLC) staging. In daily clinical practice, the shift from a stage-oriented to a therapeutic-oriented approach is needed to direct the choice of HCC treatment toward the potentially most effective option on an individual basis. The important factor in precision medicine is the promotion of patient management based on the individual approach, knowing that the final decision must be approved by a multidisciplinary expert team.
    Language English
    Publishing date 2022-01-24
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12020149
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  6. Article: Prognostic potential of circulating miR-93-5p in patients with colorectal cancer liver metastases.

    Despotović, Jovana / Bogdanović, Aleksandar / Dragičević, Sandra / Galun, Danijel / Krivokapić, Zoran / Nikolić, Aleksandra

    Neoplasma

    2022  Volume 69, Issue 2, Page(s) 430–442

    Abstract: This study aimed to examine the expression pattern of tumoral and circulating miR-93-5p in patients with colorectal cancer (CRC) liver metastasis (CRLM) and to explore its predictive and prognostic potential. CRLM tissue, surrounding non-tumor liver ... ...

    Abstract This study aimed to examine the expression pattern of tumoral and circulating miR-93-5p in patients with colorectal cancer (CRC) liver metastasis (CRLM) and to explore its predictive and prognostic potential. CRLM tissue, surrounding non-tumor liver tissue, and serum were obtained from 35 patients with CRLM. The expression pattern of tissue and circulating miR-93-5p in patients with CRLM was determined using quantitative polymerase chain reaction, using miR-16-5p for normalization. Sample-based cut-off values for CRLM and serum miR-93-5p expression were calculated using Receiver Operating Characteristic curve analysis to stratify the patients into high and low miR-93-5p expression groups which were that compared with patients' clinicopathological data, therapy response, one-year disease-free survival, and disease recurrence. Relative miR-93-5p expression was higher in CRLM in comparison to the non-metastatic liver tissue (p<0.001). CRLM miR-93-5p expression showed moderate negative correlation with carcinoembryonic antigen levels (r=-0.406; p=0.016). There were no differences in high-/low-miR-93-5p expression and therapy responders vs. non-responders, which was confirmed in vitro using metastatic and normal colonic cells SW620 and HCEC-1CT, respectively. No difference was observed in one-year recurrence-free survival in patients with high vs. low miR-93-5p expression in CRLM or serum. However, high miR-93-5p serum levels were significantly associated with early disease recurrence (p=0.035). In conclusion, miR-93-5p serum levels could be potentially used as a prognostic factor for early disease recurrence in CRLM patients.
    MeSH term(s) Biomarkers, Tumor ; Colorectal Neoplasms/genetics ; Colorectal Neoplasms/metabolism ; Humans ; Liver Neoplasms/secondary ; MicroRNAs/metabolism ; Neoplasm Recurrence, Local ; Prognosis
    Chemical Substances Biomarkers, Tumor ; MIRN93 microRNA, human ; MicroRNAs
    Language English
    Publishing date 2022-01-18
    Publishing country Slovakia
    Document type Journal Article
    ZDB-ID 415445-9
    ISSN 0028-2685
    ISSN 0028-2685
    DOI 10.4149/neo_2021_210603N749
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  7. Article ; Online: A Rare Case of Isolated Hepatocellular Carcinoma Metastasis in Left Mandibular Region in a Patient with Hepatitis C Virus Liver Cirrhosis Diagnosed after the Onset of COVID-19 Infection.

    Mašulović, Dragan / Igić, Aleksa / Filipović, Aleksandar / Zakošek, Miloš / Bulatović, Dušan / Mijović, Ksenija / Micev, Marjan / Galun, Danijel

    Medicina (Kaunas, Lithuania)

    2023  Volume 59, Issue 11

    Abstract: Background and Objectives: ...

    Abstract Background and Objectives:
    MeSH term(s) Female ; Humans ; Aged ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/pathology ; Hepacivirus ; COVID-19/complications ; Hepatitis C/complications ; Liver Cirrhosis/complications
    Language English
    Publishing date 2023-11-13
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina59111992
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  8. Article ; Online: Effect of Percutaneous Biliary Drainage on Enzyme Activity of Serum Matrix Metalloproteinase-9 in Patients with Malignant Hilar Obstructive Hyperbilirubinemia.

    Filipović, Aleksandar / Mašulović, Dragan / Gopčević, Kristina / Galun, Danijel / Igić, Aleksa / Bulatović, Dušan / Zakošek, Miloš / Filipović, Tamara

    Medicina (Kaunas, Lithuania)

    2023  Volume 59, Issue 2

    Abstract: Background and ... ...

    Abstract Background and Objectives
    MeSH term(s) Humans ; Matrix Metalloproteinase 9 ; Prospective Studies ; Cholestasis/therapy ; Neoplasms ; Bilirubin ; Drainage/methods ; Hyperbilirubinemia ; Stents ; Treatment Outcome
    Chemical Substances Matrix Metalloproteinase 9 (EC 3.4.24.35) ; Bilirubin (RFM9X3LJ49)
    Language English
    Publishing date 2023-02-10
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina59020336
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  9. Article ; Online: The Modified Sublay Technique for the Management of Major Subcostal Incisional Hernia: Long-Term Follow-up Results of 37 Consecutive Patients.

    Zuvela, Marinko / Galun, Danijel / Bogdanovic, Aleksandar / Bidzic, Nemanja / Zivanovic, Marko / Zuvela, Milos / Zuvela, Milan

    Annals of plastic surgery

    2021  Volume 88, Issue 2, Page(s) 212–218

    Abstract: Background: The aims of this study were to present the concept of original technique in the management of major incisional subcostal hernias and to evaluate short- and long-term outcome.: Method: Between January 2010 and January 2020, 280 patients ... ...

    Abstract Background: The aims of this study were to present the concept of original technique in the management of major incisional subcostal hernias and to evaluate short- and long-term outcome.
    Method: Between January 2010 and January 2020, 280 patients underwent hernia repair surgery for incisional lateral abdominal hernia at Clinic for Digestive Surgery, Clinical Center of Serbia. Among them, 37 patients underwent the modified sublay technique for major incisional subcostal hernia with minimal hernia defect surface of 100 cm2 or greater or minimal hernia defect width or height of 10 cm or greater. The operative techniques are as follows: retromuscular dissection of rectus muscle from posterior sheath on the both sides of hernia defect, external oblique muscle dissection from internal oblique muscle in a circle around hernia defect at the side of the hernia defect, complete reconstruction of the posterior myofascial layer, large heavyweight polypropylene mesh placement in a sublay position, and complete or partial reconstruction of anterior myofascial layer.
    Results: A median (range) hernia defect surface was 150 (100-500) cm2. A median operative time was 130 (90-330) minutes. The morbidity rate was 18.9%. A median (range) postoperative hospital stay was 7 (2-24) days. After the median follow-up of 50 (1-108) months, 2 patients (5.4%) developed recurrent hernia.
    Conclusions: The modified sublay technique using large heavyweight polypropylene mesh provides good results in the management of major subcostal abdominal wall defects.
    MeSH term(s) Follow-Up Studies ; Hernia, Ventral/surgery ; Herniorrhaphy ; Humans ; Incisional Hernia/surgery ; Surgical Mesh
    Language English
    Publishing date 2021-06-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 423835-7
    ISSN 1536-3708 ; 0148-7043
    ISSN (online) 1536-3708
    ISSN 0148-7043
    DOI 10.1097/SAP.0000000000002890
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  10. Article: Prognostic Significance of

    Bogdanovic, Aleksandar / Despotovic, Jovana / Galun, Danijel / Bidzic, Nemanja / Nikolic, Aleksandra / Rosic, Jovana / Krivokapic, Zoran

    Cancer management and research

    2021  Volume 13, Page(s) 163–171

    Abstract: Purpose: There are limited data on expression of epithelial-mesenchymal transition (EMT) markers in patients with colorectal liver metastases (CRLM). The study aim was to evaluate the expression and prognostic significance of E-cadherin (: Patients ... ...

    Abstract Purpose: There are limited data on expression of epithelial-mesenchymal transition (EMT) markers in patients with colorectal liver metastases (CRLM). The study aim was to evaluate the expression and prognostic significance of E-cadherin (
    Patients and methods: Thirty patients with CRLM managed by curative-intent liver resection were included in this prospective pilot study. Blood samples, colorectal liver metastases and surrounding non-tumor liver tissue were collected. Expression of
    Results: The expression of
    Conclusion: Lower expression of
    Language English
    Publishing date 2021-01-11
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2508013-1
    ISSN 1179-1322
    ISSN 1179-1322
    DOI 10.2147/CMAR.S287974
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