After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together.

A 16-year-old girl with an asymptomatic large splenic cyst. The disease was discovered by an accidental ultrasound of the abdomen due to a urinary infection. The patient was followed up conservatively for 3 years, and after the gradual enlargement of the cyst, laparoscopic surgery was indicated. The operation and postoperative follow-up for a period of 6 months is satisfactory.

No abstract available.

Self-inserted urethrovesical foreign bodies are rare in children. A 7-year-old boy inserted a hairpin into the urethra seven days before admission, a diagnosis that was made on the basis of the appearance of blood in the urine, palpation of the base of the penis and two directional X-ray imaging. Cystourethroscopy and suprapubic cystotomy were used to remove the foreign body.The presentation of urethrovesical foreign bodies can vary widely, as can the type of object inserted. Definitive treatment is usually the endoscopic removal, however occasionally surgical intervention may be required. Our novel approach enabled less traumatic removal of the hairpin

Trauma is the leading cause of pediatric mortality and abdominal injury is a significant contributor to morbidity. Abdominal trauma in the population of injured children, is the third leading cause of death in this population, after head and thoracic injuries. It is the most common cause of death owing to unrecognized injury. They most often occur in traffic accidents, games and sports. The clinical presentation depends on the severity of the injury, the injured organ and the associated injuries. Mesenteric injury from blunt abdominal trauma is uncommon and can be difficult to diagnose. It is known that seatbelt trauma from motor vehicle accidents is the most common mechanism of mesenteric injury and that the mesentery of the small bowel is injured more frequently than that of the colon. We present an unusual case, a seven-year-old boy who was injured while skiing. The patient was in a state of hemorrhagic shock and underwent emergency surgery after an urgent diagnosis. During the operation, the leading trauma and the reason for the hemorrhagic shock were found to be a mesenteric injury, and bleeding from the branches of the superior mesenteric artery. Early transport, monitoring and diagnostics significantly contribute to reducing morbidity and mortality. The standard in surgery is non-operative treatment of injured parenchymal organs. A multidisciplinary approach that includes doctors of various specialties (pediatric surgeons, pediatricians, neurosurgeons, anesthesiologists and radiologists) who contribute to the diagnosis and treatment of injured children through diagnostic and therapeutic procedures has a key role. At the end, the decision regarding surgical treatment is responsibility of pediatric surgeon.

1 Clinic of Pediatric surgery, Clinical Center University in Sarajevo, Patriotske lige 81, 71 000 Sarajevo, Bosnia and Herzegovina 2 Clinic for Anaesthesiology and Reanimation, Clinical Center University in Sarajevo, Bolnička 25, 71 000 Sarajevo, Bosnia and Herzegovina 3 Pediatric Intensive Care Department, Pediatric Clinic, Clinical Center University in Sarajevo, Patriotske lige 81, 71 000 Sarajevo, Bosnia and Herzegovina 4 Clinic of Neurosurgery, Clinical Center University in Sarajevo, Bolnička 25, 71 000 Sarajevo, Bosnia and Herzegovina Corresponding author: Asmir Jonuzi, PhD, Clinic of Pediatric surgery; Clinical Center University in Sarajevo; Patriotske lige 81, 71000 Sarajevo; Bosnia and Herzegovina e-mail: jonuziasmir@hotmail.com DOI: 10.5281/zenodo.5501485 ABSTRACT

Introduction: The incidence of N1 and N2 metastases in relation to the presence of peritumoral lymphovascular infiltration and tumor grade in bronchial carcinoma still remain insufficiently researched areas that could provide valuable guidance. Several studies have shown a statistically significant difference in the occurrence of N1 and N2 metastases in relation to the type and size of the bronchial carcinoma. The relationship between the occurrence of N1 and N2 metastases and the degree of immaturity of the tumor in the bronchial carcinoma remains insufficiently documented. Patients and methods: This study included 331 patients of all ages, both men and women, diagnosed with bronchial carcinoma using various diagnostic procedures. In these patients, surgical treatment was indicated and the anatomical resection was performed. Result: A total of 331 patients were included in the study and N1 metastases were present in 39.88% of cases, while N2 metastases were present in 4.53% of cases with bronchial carcinoma. Peritumoral lymphovascular invasion was present in 37.55% of cases (86 out of 229 patients) with N0 disease, in 55.89% of cases (128 out of 229 patients) with N1 disease, and in 6.55% of cases (15 out of 229 patients) with confirmed N2 disease. Conclusion: The presence of the peritumoral lymphovascular invasion is more often accompanied by metastases in corresponding regional lymph nodes. By calculating the total relative risk, there is almost a 30-fold higher risk of developing metastases in N1 and N2 lymph nodes in the presence of peritumoral lymphovascular invasion.