The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Georgia Luiza Serbanescu

Georgia Luiza Serbanescu

Preserving Left Aberrant Hepatic Artery During Gastrectomy for Cancer – Literature Review and Case Report

Introduction: Identifying left aberrant hepatic artery during gastrectomy for cancer is occasional. In case of replaced left hepatic artery, its ligation can lead to hepatic injury or ischemia, while preserving it can cause difficulties during lymphadenectomy. In literature there is no consensus regarding preserving replaced left hepatic artery during gastrectomy for cancer. A recent study, analysing adverse effects of ligating an aberrant left hepatic artery, shows in pacients with over 5 times elevated transaminase levels, increase in hospital length and postoperative complications. On the other hand, there are studies that consider ligation of aberrant left hepatic artery safe, the only inconvenient being postoperative transient elevation of transminase levels, when ligated artery diameter is over 1.5 mm. Matherial and methoods: We report the case of a 65 years old male, known with myocardial infarction, admitted for epigastric pain, nausea, vomiting, dysphagia for solids and important weight loss. Upper gastrointesinal endoscopy with biopsy and computed tomography showed eso-gastric tumoral mass, signet ring cell carcinoma, no metastases. Intraopertive, we found replaced left heaptic artery arising from left gastric artery, close to the celiac trunk, its diameter being approximately 1 cm. Total radical D2 gastrectomy with mechanical eso-jejunal Roux-en-Y anastomosis was performed. Postoperative evolution was favourable surgically, but the patient had SarsCov2 infection during hospitalisation The final pathology report showed 18 lymph nodes examined, 5 being with adenocarcinoma metastases. Conclusions: Preserving replaced left hepatic artery during gastectomy for cancer is preferable, lyphadecnectomy not being affected. Potential postoperative complications resulted from ligation of replaced left hepatic artery could have chanced the prognosis.

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Free Educational Android Mobile Application for Radiobiology. Evaluation of Radiation Oncologist and Medical Physicist

The use of mobile devices and applications dedicated to different medical fields has improved the quality and facilitated medical care, especially in the last 10 years. The number of applications running on the software platforms of smart phones or other smart devices is constantly growing. Radiotherapy also benefits from applications (apps) for TNM staging of cancers, for target volume delineation and toxicity management but also from radiobiological apps for calculating equivalent dose schemes for different dose fractionation regimens. In the context of the increasingly
frequent use of altered fractionation schemes, the use of radiobiological models and calculations based on the linear quadratic model (LQ) becomes a necessity. We aim to evaluate free radiobiology apps for the Android software platform. Given the global educational deficit, the lack of experts and the concordance between radiobiology education and the need to use basic clinical notions of modern radiotherapy, the existence of free apps for the Android platform running on older generation processors can transform even an old smart device in a powerful „radiobiology station.” Apps for radiobiology can help the radiation oncologist and medical physicist with responsibilities in radiotherapy treatment planning in the context of accelerated adoption of hypo-fractionation regimens and calculation of the effect of treatment gaps, a topic of interest in the COVID-19 pandemic context. Radiobiology apps can also partially fill the educational gap in radiobiology by arousing the interest of young radiation oncologists to deepen the growing universe of fundamental and clinical radiobiology.

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Cardiotoxicity of Multimodal Treatment for Breast Cancer

In the era of the optimal and the personalized oncological treatments, life expectancy increases, therewith the need of understanding and managing side effects is a challenging task.
The most notable research advances in breast cancer involve new radiation treatments techniques and targeted therapies.
Cardiac toxicity following radiotherapy (RT) is recognized as an important issue. Furthermore, with the prevalent and necessary treatment with anthracyclines and trastuzumab, which carry an independent and confirmed risk of cardiotoxicity[1-3] the additional heart disease risk following radiotherapy must be kept to a minimum. [...]

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Metachronous Cancers

According to GLOBOCAN, cervical cancer is the fourth most common cancer worldwide touching woman, with approximately around 500000 new cases and 266000 deaths in 2012; in Romania, cervical cancer is the second malignancy diagnosed in women. Cervical cancer is responsible for 7.5% from the whole female cancer deaths and 87% of these cases are encountered in the less developed regions of the world. The more advanced is the stage of cervical cancer, the worse the prognosis is and the treatment in these cases is mainly palliative with an average survival period of only 7 years as observed in recurrent and/or metastatic cancer [...]

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