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The acute appendix is one of the most common acute illnesses encountered in "Abdominal Surgery" and Emergency Disorders in Health Institutions in Kosovo. The most important implication of the appendix is acute appendicitis, which is the most common surgical emergency worldwide. The inflammation of the appendix is generally secondary to obstruction of the lumen of the appendix. Most commonly lymphoid hyperplasia, fecoliths, foreign bodies, tumors or parasites cause it. The disease is present at all ages, but mostly between the ages of 10 to 30 years rarely before the age of 2 and the elderly. Purpose of the study is to present in a more comprehensive, detailed way a pathology very frequent, and often create severe situations during the daily professional work that nurses develop in health care. Also, the presentation of quantitative and qualitative data regarding the treatment of appendectomies in the "Abdominal Surgery Clinic" -in the University Clinical Center of Kosovo (UCCK), the number of treated patients and the methods used. The study included 134 patients in the Department of "Abdominal Surgery B" at the University Clinical Center of Kosovo (UCCK) in January-December 2019. The database included in this study consists of data obtained from the operation register as well as contacting the medical staff. Also, all patients after the diagnosis are treated surgically. The scenes are divided by sex, age, and place of residence. From the patient protocol book at Abdominal B Surgery Department, data for 134 diagnosed patients with pronounced accumulation during January-December 2019 were collected. Activities: Acute Appendix remains the most common type of surgical interventions in the "Surgery Clinic". [ABSTRACT FROM AUTHOR]

Bacterial otitis is more common in livestock in a feedlot environment. Otitis externais an inflammation of the external auditory meatus and pinna that is similar to epithelium and soft tissue infection. Acute localized disease in sheep occurs in the form of pustules, furuncles or crusts in wooled areas and typically result from Staphylococcus aureus. In Romania, there are little studies on the otitis in sheep; therefore the purpose of this study was to manage clinical and chirurgical the case, to determine the bacterial agents from that area and its sensitivity to antibiotic. A three years old female crossbred sheep, pregnant in the 4 th month, from Giurgiu county was examined, this thing revealed display unilateral head tilt (toward the left side of the lesion), left ear ptosis. Ultrasonographic and radio graphical images describe the inflammation of peripheral ear conduct tissue but no bulla damage. The diameter of the ear canal had 0,35 cm. The bacterial species isolated were Staphylococcus aureus and Proteus spp., and were sensitive to Ciprofloxacin and Amoxicillin. Seven days after the surgery the head and left ear were drooped (sequelae of the cranial nerve VII and cranial nerve VIII) but no inflammation or pain were seen. The conclusion is that the lateral left ear canal resection may be a reliable surgical method for the sheep otitis if it is made rapidly after the otitis diagnosis. [ABSTRACT FROM AUTHOR]

Babies born with clefts of the lip, and the alveolus or palate, or both, require multidisciplinary, highly specialised treatment from birth to early adulthood. We review the contemporary management of clefts and outline the current treatment protocol adopted by cleft networks in the United Kingdom. We also look at the level of evidence and the restructuring of services that has defined current practice. In light of the recent Cleft Care UK study, we ask whether it is now time to adopt a new philosophy towards the surgical techniques that are used. [ABSTRACT FROM AUTHOR]

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Abstract: In a prospective study, a large number of patients with basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) underwent surgery using three dimensional (3D) histology and were evaluated with respect to local recurrence. The excised tumours were treated using 3D-histology with a routine paraffin procedure until the surgical margins were clear of tumour. Prospective evaluation of recurrence-free survival and overall survival of 5227 primary BCCs in 3320 patients and 615 invasive primary SCCs in 600 patients was conducted in the form of a letter-based follow-up with feedback from the patients and the referring physicians. The mean follow-up period was 5 years. In the BCC collective, 36 out of 3320 patients developed local recurrence (1%, calculated as a percentage of treated BCCs: 0.7%). In the SCC collective, 20 local recurrences appeared (3%). The recurrence rate for SCCs with desmoplasia was 24%, whilst the recurrence rate for common types of SCC without desmoplasia was 1%. Surgery followed by 3D histology results in very low recurrence rates for BCC and SCC with no additional effort compared with the normal histopathological procedure. [Copyright &y& Elsevier]

PURPOSE: Isolated locoregional disease accounts for approximately 20 percent of recurrences after treatment for colorectal cancer. It has been suggested that complete resection of these recurrences can result in increased survival. The value of surgery for isolated retroperitoneal recurrences has not been well defined. We have sought to characterize outcome and survival in patients undergoing resection for isolated retroperitoneal recurrences of colorectal cancer. METHODS: From a prospective database, 25 patients were identified as having undergone surgical exploration with curative intent for isolated retroperitoneal recurrences of colorectal cancer between 1988 and 1999. Variables studied included age, gender, location and size of the tumor, extent of resection, disease-free interval, and morbidity and mortality. Statistical analyses were performed using the log-rank test and Kaplan-Meier estimates, with overall survival as the primary end point. RESULTS: The study population consisted of 25 patients (13 males), with a median age of 55 years and a median follow-up of 29 (range, 1–151) months. The median time to first retroperitoneal recurrence was 23 (range, 3–72) months. Twenty patients underwent resection, whereas five patients were deemed unresectable at the time of operation. The median survival in patients who underwent resection patients was 31 months compared with 3 months in those patients who did not undergo resection (P = 0.0001). Analysis of the entire group demonstrated a disease-free interval of greater than 24 months to be a positive predictor of outcome (median survival, 30 vs. 48 months; P = 0.02). For patients undergoing resection, the presence of positive margins (P = 0.01) and tumor size ≥5 cm (P = 0.008) predicted a worse prognosis. In patients who underwent resection, the two-year and five-year overall survival rates were 60 and 15 percent, respectively. CONCLUSIONS: Patients with isolated retroperitoneal recurrences of colorectal cancer generally have a poor prognosis. However, a longer disease-free interval, complete negative-margin resection, and smaller tumor size are associated with long-term survival in selected patients. [ABSTRACT FROM AUTHOR]

PURPOSE: Tumor cells may suppress activation of the host’s complement system, and the functional state of the complement system may be a prognostic marker of outcome in patients with malignancies. Serial plasma samples from patients undergoing intended curative surgery for colorectal cancer were analyzed for complement factor C3 activation capacity. METHODS: Samples were collected from 91 patients with colorectal cancer and 13 with benign colorectal diseases before surgery and 1, 2, and 7 days after surgery, between 8 and 13 days after surgery, and 3, 6, 12, 18, 24, 36, 48, and 60 months after surgery. The samples were analyzed with an enzyme-linked immunosorbent assay that measured C3 activation capacity by the alternative and classic complement pathways. Cancer patients were compared according to Dukes stage, type of surgery performed, transfusion of blood, development of infection, venous thromboembolism, and cancer recurrence. RESULTS: Plasma samples obtained from cancer patients before surgery showed C3 activation capacities corresponding to those of samples from patients with benign disease. For both patient groups, C3 activation capacity decreased after surgery and normalized within seven days. Significant differences in C3 activation capacities were observed between cancer patients that were related to Dukes stage and in patients with and without buffy coat-depleted red cells suspended in saline, adenine, glucose, and mannitol transfusion, infectious events, and deep venous thromboembolism. Measurement of C3 activation capacity was of predictive value in patients who developed infection. CONCLUSION: Serial measurements of C3 activation capacity in plasma from patients who had undergone surgery for colorectal cancer revealed significant differences related to Dukes staging after surgery and to the development of infections but not to cancer recurrence. [ABSTRACT FROM AUTHOR]

We evaluated referral patterns for the initial surgery in patients with suspected ovarian cancer and factors associated with that referral. Through a mailed survey we asked gynecologists: (i) to rate the importance of characteristics of the patient, the mass, the surgeon and the hospital on to their decision to operate on or to refer to a gynecologic oncologist a patient with a pelvic mass; (ii) to indicate whether they would operate on or refer five hypothetical patients with masses of increasing complexity; (iii) to estimate on what proportion of patients with suspected ovarian cancer in their practice they currently operate; and (iv) to estimate the residual tumor volume when they perform surgery for ovarian cancer. Gynecologists seeing fewer patients with suspected ovarian cancers, in a teaching vs community hospital, in full-time university vs private practice and working in specific geographical areas, referred more to an oncologist for the primary surgery. Not significant were the gender of the surgeon, number of years in practice and distance to a regional cancer center. A high probability of cancer and characteristics of the surgeon affected referral patterns. [ABSTRACT FROM AUTHOR]

The results of this retrospective case study indicate that a composite of tumor grade, pattern of spread and substage at the time of opening affects the outcome most in the treatment of stage III epithelial tumors of the ovary. The poorest prognosis was associated with grade 3 histology, a pattern of spread requiring extensive and often difficult surgery for removal and a high substage. The best prognosis was usually associated with grade 1, with either very easily removed, isolated spread or low substage.The extent of tumor defined the degree of primary cytoreduction possible. If the tumor was minimally extensive, primary cytoreduction results were excellent. The same conclusions were reached in the case of secondary cytoreduction at the time of second-look procedure. There was no statistically significant difference (z = 1.481, P = 0.069) in 5-year survival between patients with microscopic only disease (59%) at second-look, and patients with gross disease not cytoreduced (36%). [ABSTRACT FROM AUTHOR]

Fifty-two intestinal operations were performed during 45 laparatomies in 43 non-obstructed ovarian cancer patients. The histology of the tumor was serous in 29/43 cases (67.5%). The gross postoperative morbidity rate was 15.5% and postoperative mortality rate 6.9%. The 5-year survival was 28.3%, and was not affected by the time of intestinal surgery (during the first or following laparotomies). As a result, intestinal surgery in advanced ovarian cancer patients is feasible without an undue increase in morbidity. However, it must be carefully tailored because, though contributing to the quality of life of these patients, it does not seem to affect their survival, at least in this retrospective series. [ABSTRACT FROM AUTHOR]

From January 1975 to December 1991, 34 patients with a diagnosis of epithelial ovarian tumors of low malignant potential (LMP) were admitted to the Istituto Nazionale Tumori of Milan. Eighteen of them (group 1) underwent complete staging laparotomy and retroperitoneal para-aortic and pelvic lymphadenectomy, as for ovarian cancer. In the remaining 16 cases (group 2), the surgical treatment ranged from unilateral oophorectomy to incomplete staging procedure. In group 1, nine patients (50%) were found to have retroperitoneal nodal involvement. In group 2, all patients had stage I disease. Patients were followed up for 20-222 months (mean 108, median 86). There were two recurrences in group 2 (after 5 years) and none in group 1 (NS). Currently all patients are alive and disease free. Nine of 18 group 1 patients were upstaged to stage III on the basis of lymph node involvement only. However, at least in this retrospective series, lymph node metastases did not affect prognosis or survival. [ABSTRACT FROM AUTHOR]

Between 1970 and 1990, 160 patients with malignant non-dysgerminomatous ovarian germ cell tumors have been treated at our own institution. Primary therapy failed in 42 of these patients, who constitute the basis for this study. Seventeen patients had stage I disease, 5 stage II, 17 stage III, and 3 stage IV. Histologic type included 13 immature teratomas, 8 endodermal sinus tumors, and 21 mixed germ cell tumors. Primary therapy for 14 patients was surgery alone, for 23, surgery plus chemotherapy, for 2, surgery plus radiotherapy and for 3, all three modalities. Median progression-free survival from initial diagnosis lasted 6.8 months (range, 0.9-24 months). Thirty-four patients received chemotherapy as part of salvage; 5/11 (45%) who received VAC are disease-free, and 6/11 (55%) who received cisplatin combinations are disease-free. When primary VAC failed, 3/7 (43%) were salvaged with cisplatin combinations. When primary cisplatin combinations failed, 2/5 (40%) were salvaged. Twelve of the 42 patients (29%) are currently alive disease-free. Primary treatment failure was attributed to surgery alone for 14 patients (7 because of misdiagnosis), radiotherapy for 5, and toxicity for 1. Of the 22 patients who failed chemotherapy, 12 did so because of a suboptimal regimen, 3 because of possible dose-intensity problems, one because of non-compliance, and 6 for unexplained reasons. Patients with ovarian germ cell tumors have an excellent probability of cure with aggressive primary therapy, but successful salvage may be difficult when primary treatment fails. [ABSTRACT FROM AUTHOR]

The medical records of 45- patients with intraoperative diagnosis of borderline or low malignant potential (LMP) ovarian tumor were reviewed to identify factors affecting intraoperative management. The correlation between gross and histologic staging was examined, as was the complication rate following surgery. Patient age and presence of qualifying pathologic terms on frozen section diagnosis were the only important factors relating to performance of surgical procedure. Surgical complications were closely associated with non-conservative surgery. Thirteen of 14 (92.8%) patients with significant complications had a hysterectomy. These 14 patients had staging procedures at essentially the same rate as the entire population. Thirteen of 45 patients (28.8%) thought to have LMP by frozen section had a different diagnosis on permanent review; 5 were benign and 8 were frankly malignant, confirming the limitations of frozen section in the diagnosis of LMP ovarian tumor. Of 40 with LMP or frankly malignant tumors 5(12.5%) were upstaged based on unsuspected histopathologic findings. These results indicate the need for a standard approach to staging in patients who are suspected to have an LMP ovarian tumor and should encourage the performance of conservative surgery when appropriate. [ABSTRACT FROM AUTHOR]