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"PURPOSE: To assess the safety and feasibility of laparoscopic gastrectomy (LG) for gastric cancer patients with a history of abdominal surgery (HAS).METHODS: This retrospective study analyzed data collected from gastric cancer patients with HAS, who underwent LG between 2004 and 2015. We compared the clinicopathological features that correlated with conversion to open surgery and the development of severe postoperative complications (Clavien-Dindo classification of grade III or higher).RESULTS: Of the 41 patients identified, 6 (14.6%) required conversion to open surgery. The incidence of conversion to open surgery was associated with a history of lower gastrointestinal tract surgery (p = 0.009), attempted laparoscopic total gastrectomy (p = 0.002), and excessive blood loss (p < 0.001). Severe postoperative complications developed in six patients (14.6%). Although the development of complications was associated with high postoperative serum C-reactive protein, the type of past abdominal surgery was not significantly correlated with severe complications.CONCLUSIONS: LG was feasible for gastric cancer patients with a HAS, but for those with a history of lower abdominal surgery or those who require total gastrectomy, surgeons should carefully consider the indications for LG."

"This unique, findings-oriented guide to computed tomography is organized to reflect the way radiologists really work: progressing from general impressions to definitive diagnoses. In nearly 1000 high-quality scabs, the radiologist will find CT findings depicting frequently encountered congenital and acquired diseases and disorders. Included in the wide-ranging survey of CT findings are traumatic injuries; congenital anomalies; and infectious, inflammatory, neoplastic, and degenerative disease processes. For convenience, these are grouped anatomically by brain, head and neck, spine, musculoskeletal system, chest, abdomen, and pelvis. In addition, the book's extensive index systematically cross-references diseases and CT findings, providing even greater accessibility to key information"--Provided by publisher."

"Latar Belakang: Radioterapi baik sebagai terapi tunggal maupun sebagai terapi kombinasi, memegang peranan yang penting dalam penatalaksanaan kanker payudara kiri. Eskalasi dosis dikatakan mampu meningkatkan kontrol dan menurunkan angka kekambuhan namun di sisi lain dapat meningkatkan angka toksisitas. Hingga saat ini masih terus dilakukan studi untuk menganalisis parameter dosimetri diantara teknik Three Dimensional Conformal Radiotherapy-Field and Field, Volumetric Modulated Arc Therapy, dan Helical Tomotherapy pada kanker payudara di departemen Radioterapi RSUPN-CM. Metode: Studi eksperimental eksploratorik dengan melakukan intervensi pada 10 data CT plan pasien kanker payudara kiri yang diradiasi di Departemen Radioterapi RSUPN-CM. Dosis 50 Gy diberikan pada PTV dalam 25 fraksi. Cakupan PTV dievaluasi menggunakan Indeks konformitas CI dan indeks homogenitas HI. Menilai perbandingan PTV lokal D98, D95, D2, D50 dan supraklavikula dan menilai organ kritis sekitar target seperti paru kiri ipsilateral V20 le; 30, paru kanan contralateral V5 le; 50, jantung V25 le;10, payudara kanan contralateral Dmean < 5Gy. Hasil: Dari hasil analisis statistik tidak ditemukan adanya perbedaan yang bermakna antara 3DCRT-FIF, VMAT maupun HT dalam mencapai dosis D98 dan D95, pada D50 terdapat perbedaan yang bermakna antara 3DCRT-FIF dengan VMAT p=0,000, 3DCRT-FIF dengan HT p=0,000, namun tidak terdapat perbedaan yang bermakna antara VMAT dengan HT p=0,508. Dalam hal ini, ketiga teknik mampu memberikan cakupan dosis minimal yang baik pada volume target, meskipun begitu dari hasil penelitian ini teknik HT mampu memberikan nilai rerata D95 yang superior. Untuk D50 lokal ditemukan adanya perbedaan yang bermakna di 3 kelompok yang ada yaitu antara 3DCRT-FIF dengan VMAT p=0,000, 3DCRT-FIF dengan HT p=0,000, maupun VMAT dengan HT p=0,005. Didapat teknik HT memiliki nilai rerata D50 yang paling baik 50.01 0.25. Untuk D2 dari hasil analisis statistik ditemukan adanya perbedaan yang bermakna di 3 kelompok yang ada yaitu antara 3DCRT-FIF dengan VMAT p=0,005, 3DCRT-FIF dengan HT p=0,005, maupun VMAT dengan HT p=0,005.Kesimpulan: Tidak terdapat perbedaan bermakna rerata D98 dan D95, namun terdapat perbedaan bermakna pada cakupan dosis D2 dan D50 antara teknik 3DCRT-FIF vs VMAT, 3DCRT-FIF vs HT, dan VMAT vs HT, seluruhnya memperlihatkan perbedaan yang bermakna p < 0,05 . Rerata durasi penyinaran paling tinggi didapatkan dengan teknik HT dan paling rendah pada 3DCRT-FIF.

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Background: Radiotherapy as a main or combination therapy, holds an important role in the management of left breast cancer. Dose escalation is said to increase control and lower recurrence rate. On the other hand, dose escalation increases toxicity. Until now there is many study comparing dosimetry parameters between three different techniques; Three Dimensional Conformal Radiotherapy ndash; Field and Field 3DCRT-FIF, Volumetric Modulated Arc Therapy VMAT and Helical Tomotherapy HT and in relation to left breast cancer in radiotherapy department RSUPN-CM. Method: This is an experimental study with intervention on 10 left breast cancer patients, CT planning data. All the subjects underwent radiation in radiotherapy department RSUPN-CM. 50 Gy dose in 25 fractions was given for PTV. Afterwards, PTV coverage was evaluated using conformity index CI and homogeneity index HI . Comparison of critical organs was evaluated using Dmax le; 50 Gy spinal cord, V25 le; 10 heart, V20 le; 30 lung ipsilateral and V5 le; 30 lung contraleteral and Dmean < 5 Gy right breast. Results: From the statistical analysis there is no difference between 3DCRT-FIF, VMAT and HT in achieving D98 in local PTV. At the D95 value there is a difference between 3DCRT- and VMAT p = 0.022, 3DCRT-FIF with HT p = 0.005, but no value exists between VMAT and HT p = 0.508. In this case, one of the techniques employed gives a good minimum amount of volume targets, although the results of this technique HT are able to provide a superior D95% average. For D50% locally found, there are three groups that exist between 3DCRT-FIF with VMAT p = 0,000, 3DCRT-FIF with HT p = 0,000, and VMAT with HT p = 0,005. HT technique has the highest mean D50 50.01 0.25. For D2 of the analysis results found there were significant differences in 3 groups that existed between 3DCRT-FIF with VMAT p = 0,005, 3DCRT-FIF with HT p = 0,005, and VMAT with HT p = 0,005.Conclusion: There is no D98% and D95%, but there is still a difference with D2% and D50% between 3DCRT-FIF vs VMAT, 3DCRT-FIF vs HT, and VMAT vs HT, all significant differences (p <0.05). The highest average duration of exposure with HT and lowest on 3DCRT-FIF."