Background: In the last few decades, many techniques have been developed to correct prominent ear deformities. Modified Chong-Chet otoplasty represents a new and improved classical Chong-Chet procedure for prominent ear surgery. This study evaluates and compares the long-term results of standard Chong-Chet otoplasty with the modified technique. Methods: A retrospective study was conducted on patients undergoing otoplasty at the Special Hospital S-tetik Banja Luka between January 17, 2017, and February 5, 2019. The total number of patients undergoing the procedure was 129. The first group (48 patients) underwent otoplasty using the Chong-Chet technique, while the second group (81 patients) underwent a modified Chong-Chet procedure. All patients were randomly selected on the condition that the antihelix was absent. The data were processed and analyzed using the Statistical Package for the Social Sciences version 24 using nonparametric tests (χ 2 test, Mann–Whitney U test and Kruskal–Wallis test). Results: Every second patient was satisfied (19 patients were partially satisfied and five patients were completely satisfied) with the results of the classical Chong-Chet technique. Seven patients were neither satisfied nor dissatisfied, while 17 patients were dissatisfied (11 patients were completely dissatisfied and 6 patients were mostly dissatisfied). As for the modified method, on average, nine out of 10 patients (73 or 90.1%) were satisfied, of which 49 patients (60.5%) were completely satisfied and 24 patients (29.6%) were mostly satisfied. The statistical significance was P < .05. Research results point to the modified Chong-Chet technique being a significant improvement to the classical method. Conclusion: Modified Chong-Chet technique increases the number of positive long-term results and significantly improves the standard method.

Introduction: Sentinel lymph node biopsy is a standard staging procedure in patients with early breast cancer. Aim of the study is a validation procedure of sentinel lymph node biopsy (SLNB) in our institution and comparison between two mapping techniques-isotope mapping and methylene blue dye for lymphatic mapping. Material and methods: The study comprised 75 women with breast cancer of clinical stage T1-2N0M0. We analyzed patients from June, 2010 to March, 2013. In 39 patients, (Group A) lymphatic mapping technique was performed by using the peritumoral injection of 37MBq activity isotope (99m Technetium NANOCIS),and in 36 patients (Group B) mapping technique was performed by using the periareolar injection of 2-4 ml blue dye (Methylene blue 1%). Axillary dissection was performed in both groups after SLNB. Results: Out of 75 patients, sentinel lymph node was identified in 68 (90.7%). Identification rate was similar between the groups-89.7% (Group A), 91.7% (Group B). Accuracy rate was 97% between the groups, that is, Group A 97.1% and Group B 96.9%. In relation to the Group A (90.6%), sensitivity rate was slightly higher in the Group B-91.6%,. False negative rate of SLNB was higher in the Group A (9.1%) in relation to the Group B (8.3%). The average number of sentinel nodes detected in both groups was 1.2. Conclusion: The results of the study confirmed and validated both methods of lymphatic mapping techniques in SLNB. There were no significant statistical differences (p>0.05) in accuracy, sensitivity and false negative rate between these two groups.

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Background: One of the earliest signs of breast cancer may be the presence of mammographically detected suspicious microcalcifications in the breast. The aim of the study was to present an open surgical biopsy of the mammographically detected suspicious microcalcifications in a breast, with preoperative wire marking of the lesions and intraoperative specimen radiography, as a reliable and valid procedure.Material and Methods: The study included 80 female patients underwent surgery because of mammographically detected suspicious microcalcifications. The method of preoperative ultrasound-guided wire marking of a zone of microcalcification was performed in all patients.After wire marking, the control native mammography in ML and CC projections was performed, in order to locate the microcalcifications relative to the wire. In all patients, the extirpation of the suspicious microcalcifications was verified by the specimen radiography.Results: In the definitive histopathological finding in situ component of ductal carcinoma of the breast was verified in nine (11,25%) examinees. High grade in situ component was verified in eight (10%) examinees and low grade in situ component in one examinee (1,25%). In 11 (13,75%) examinees, the invasive breast cancer with an extensive in situ component up to 50% was verified. In 46 (57,5%) of the examinees, benign, non-proliferative changes were verified, while proliferative changes characterized as premalignant condition (sclerosing adenosis, radial scar and atypical ductal hyperplasia) were verified in 14 (17,5%) examinees. Microcalcifications verified by specimen radiography are completely removed.Conclusion: Presence of mammographically detected suspicious microcalcifications has a significant predictive value in the early detection of breast cancer. The method of an open surgical biopsy, as an alternative to stereotactic biopsy, is valid in diagnostic of the mammographically suspicious microcalcifications.

Introduction: Gastrectomy is one of the most common surgical methods for the treatment of gastric cancer, which basically destroys the mechanism and digestion chemistry. Reconstruction after gastrectomy attempts to optimize the antireflux and nutritive component of the postgastrectomic syndrome.Objective: To determine which reconstructive method after gastrectomy has the optimal synthesis of antireflux and nutritional components.Patients and Methods: 111 patients were treated for gastric malignancies at the Surgical Clinic of the University Clinical Center in Banja Luka, which were operated with the intention of achieving curability.Results: Based on Fisher’s exact probability test there is no statistically significant difference (p> 0.05) in mortality compared to the restoration of digestive continuity after gastrectomy. Reflux oesophagitis is the dominant modality of morbidity in omega-loop reconstruction (p <0.05). There is no statistically significant difference (p> 0.05) in late dumping syndrome in patients relative to individual gastric substitution options. In the Hunt-Lawrence-Rodino pouch reconstruction option, there is no statistically significant difference (p> 0.05) in the participation of individual modalities of meal quantity in relation to the condition before the disease or the modality of the nutritional status. .Conclusion: The results indicate the antireflux component of reconstruction Roux en Y and the advantage of the nutritive component in the loop modification (the creation of the Hunt-Lawrence-Rodino pouch).

Introduction Described in 1943 for the first time, breast necrosis during anticoagulant therapy is only rarely encountered in clinical practice. The objective of the article is to describe a patient who underwent anticoagulant therapy and developed breast necrosis during it. Case outline A 57-year-old female patient was admitted to hospital with pain in her left breast, which upon examination showed to be erythematous, swelled, and hard. She had started experiencing the symptoms a few days earlier, and denied having had a fever. Over the previous four weeks she had received anticoagulant treatment (acenocoumarol) as popliteal embolectomy prophylaxis. The breast was firm, edematous, of limited mobility, and with no pectoral muscle infiltration. The breast ultrasound showed a homogeneous mass, with no signs of fluid retention or suspicious lesions. Upon admission, the patient began receiving intravenous antibiotic treatment and underwent blood tests. The second day upon admission, the patient's breast revealed a clearly demarcated area of necrotic skin. Surgical treatment was indicated. The surgery was performed in two stages, the first of which included a partial resection of the necrotic breast tissue, and the second simplex mastectomy. Histological analysis showed severe superficial necrosis, with underlying diffuse deep venous thrombosis and marked arteritis of medium and small vessels. Focal areas of extensive necrosis were found deep in the breast parenchyma. Conclusion Considering that breast necrosis is extremely rare, it is usually not suspected initially. Learning about the patient's undergoing anticoagulant therapy is of crucial importance for reaching the right diagnosis. Breast abscesses should also be ruled out. Surgery is the treatment of choice, as changes to the breast tissue are usually irreversible.

Aneurysm of the visceral arteries is a rare condition and it represents around 1% of all arterial aneurisms. Aneurysm of the inferior pancreaticoduodenal artery represents around 2% of all visceral aneurysms. Aneurysm associated with occlusion of the coeliac trunk is very rare condition and there are only about 40 cases presented in the literature. In our study, we presented 56 year-old female admitted to hospital with obstructive jaundice. CT scan diagnosed tumor of the head of pancreas and CT angiography confirmed aneurysm of the inferior pancreaticoduodenal artery which was successfully operated at our clinic.

The HERe2cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards from healthcare institutions in Bosnia and Herzegovina, was initiated with the aim of defining an optimal approach to the diagnosis and treatment of HER2 positive breast cancer. After individual multidisciplinary consensus meetings were held in all oncology centers in Bosnia and Herzegovina, a final consensus meeting was held in order to reconcile the final conclusions discussed in individual meetings. Guidelines were adopted by consensus, based on the presentations and suggestions of experts, which were first discussed in a panel discussion and then agreed electronically between all the authors mentioned. The conclusions of the panel discussion represent the consensus of experts in the field of breast cancer diagnosis and treatment in Bosnia and Herzegovina. The objectives of the guidelines include the standardization, harmonization and optimization of the procedures for the diagnosis, treatment and monitoring of patients with HER2-positive breast cancer, all of which should lead to an improvement in the quality of health care of mentioned patients. The initial treatment plan for patients with HER2-positive breast cancer must be made by a multidisciplinary tumor board comprised of at least: a medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.