TY  - JOUR
AU  - Petrović, Borislava
AU  - Vicko, Ferenc
AU  - Radovanović, Dragana
AU  - Samac, Jelena
AU  - Tot, Arpad
AU  - Radovanović, Zoran
AU  - Ivković- Kapicl, Tatjana
AU  - Lukić, Dejan
AU  - Marjanović, Milana
AU  - Ivanov, Olivera
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/10039
AB  - IntroductionSentinel node biopsy is a procedure used for axillary nodal staging in breast cancer surgery. The process uses radioactive 99mTc isotope for mapping the sentinel node(s) and all the staff involved in the procedure is potentially exposed to ionizing radiation. The colloid for radiolabelling (antimone-sulphide) with 99mTc isotope (half-life 6 h) is injected into the patient breast. The injection has activity of 18.5 MBq. The surgeon removes the primary tumor and detects active lymph nodes with gamma detection unit. The tumor as well as the active nodal tissue is transferred to pathologist for the definitive findings. The aim of the study was to measure dose equivalents to extremities and whole body for all staff and suggest practice improvement in order to minimize exposure risk.Materials and methodsThe measurements of the following operational quantities were performed: Hp(10) personal dose equivalent to whole body and Hp(0.07) to extremities for staff as well as ambiental dose for operating theatre and during injection. Hp(0.07) were measured at surgeon’s finger by ring thermoluminescent dosimeter (TLD) type MTS-N, and reader RADOS RE2000. Surgeon and nurse were wearing TLD personal dosimeter at the chest level. Anesthesiologist and anesthetist were wearing electronic personal dosimeters, while pathologist was wearing ring TLD while manipulating tissue samples. Electronic dosimeters used were manufactured by Polimaster, type PM1610. All TLD and electronic dosimeters data were reported, including background radiation. Background radiation was also monitored separately. Personal TLDs are standard for this type of personal monitoring, provided by accredited laboratory. Measurements of ambiental dose in workplaces of other staff involved around the patient was performed before the surgery took place, by calibrated survey meters manufactured by Atomtex, type 1667. The study involved two surgeons and one pathologist, two anesthesiologists and three anesthetists during two months period.Results and discussionThe doses received by all staff are evaluated using passive and active personal dosimeters and ambiental dose monitors and practice was improved based on results collected. Average annual whole body dose for all staff involved in the procedure was less than 0.8 mSv. Extremity dose equivalents to surgeon and pathologist were far below the limits set for professionally exposed (surgeon) and for public (pathologist).ConclusionsAlthough has proven to be very safe for all staff, additional measures for radiation protection, in accordance to ALARA principle (As Low As Reasonably Achievable) should be conducted. The recommendations for practice improvement with respect to radiation protection were issued.
T2  - Physica Medica
T1  - Occupational radiation dose of personnel involved in sentinel node biopsy procedure
VL  - 91
SP  - 117
EP  - 120
DO  - 10.1016/j.ejmp.2021.10.019
ER  - 

@article{
author = "Petrović, Borislava and Vicko, Ferenc and Radovanović, Dragana and Samac, Jelena and Tot, Arpad and Radovanović, Zoran and Ivković- Kapicl, Tatjana and Lukić, Dejan and Marjanović, Milana and Ivanov, Olivera",
year = "2021",
abstract = "IntroductionSentinel node biopsy is a procedure used for axillary nodal staging in breast cancer surgery. The process uses radioactive 99mTc isotope for mapping the sentinel node(s) and all the staff involved in the procedure is potentially exposed to ionizing radiation. The colloid for radiolabelling (antimone-sulphide) with 99mTc isotope (half-life 6 h) is injected into the patient breast. The injection has activity of 18.5 MBq. The surgeon removes the primary tumor and detects active lymph nodes with gamma detection unit. The tumor as well as the active nodal tissue is transferred to pathologist for the definitive findings. The aim of the study was to measure dose equivalents to extremities and whole body for all staff and suggest practice improvement in order to minimize exposure risk.Materials and methodsThe measurements of the following operational quantities were performed: Hp(10) personal dose equivalent to whole body and Hp(0.07) to extremities for staff as well as ambiental dose for operating theatre and during injection. Hp(0.07) were measured at surgeon’s finger by ring thermoluminescent dosimeter (TLD) type MTS-N, and reader RADOS RE2000. Surgeon and nurse were wearing TLD personal dosimeter at the chest level. Anesthesiologist and anesthetist were wearing electronic personal dosimeters, while pathologist was wearing ring TLD while manipulating tissue samples. Electronic dosimeters used were manufactured by Polimaster, type PM1610. All TLD and electronic dosimeters data were reported, including background radiation. Background radiation was also monitored separately. Personal TLDs are standard for this type of personal monitoring, provided by accredited laboratory. Measurements of ambiental dose in workplaces of other staff involved around the patient was performed before the surgery took place, by calibrated survey meters manufactured by Atomtex, type 1667. The study involved two surgeons and one pathologist, two anesthesiologists and three anesthetists during two months period.Results and discussionThe doses received by all staff are evaluated using passive and active personal dosimeters and ambiental dose monitors and practice was improved based on results collected. Average annual whole body dose for all staff involved in the procedure was less than 0.8 mSv. Extremity dose equivalents to surgeon and pathologist were far below the limits set for professionally exposed (surgeon) and for public (pathologist).ConclusionsAlthough has proven to be very safe for all staff, additional measures for radiation protection, in accordance to ALARA principle (As Low As Reasonably Achievable) should be conducted. The recommendations for practice improvement with respect to radiation protection were issued.",
journal = "Physica Medica",
title = "Occupational radiation dose of personnel involved in sentinel node biopsy procedure",
volume = "91",
pages = "117-120",
doi = "10.1016/j.ejmp.2021.10.019"
}

Petrović, B., Vicko, F., Radovanović, D., Samac, J., Tot, A., Radovanović, Z., Ivković- Kapicl, T., Lukić, D., Marjanović, M.,& Ivanov, O.. (2021). Occupational radiation dose of personnel involved in sentinel node biopsy procedure. in Physica Medica, 91, 117-120.
https://doi.org/10.1016/j.ejmp.2021.10.019

Petrović B, Vicko F, Radovanović D, Samac J, Tot A, Radovanović Z, Ivković- Kapicl T, Lukić D, Marjanović M, Ivanov O. Occupational radiation dose of personnel involved in sentinel node biopsy procedure. in Physica Medica. 2021;91:117-120.
doi:10.1016/j.ejmp.2021.10.019 .

Petrović, Borislava, Vicko, Ferenc, Radovanović, Dragana, Samac, Jelena, Tot, Arpad, Radovanović, Zoran, Ivković- Kapicl, Tatjana, Lukić, Dejan, Marjanović, Milana, Ivanov, Olivera, "Occupational radiation dose of personnel involved in sentinel node biopsy procedure" in Physica Medica, 91 (2021):117-120,
https://doi.org/10.1016/j.ejmp.2021.10.019 . .

TY  - JOUR
AU  - Pinkney, T.
AU  - Gvozdenović, M.
AU  - Jovanović, Dragana J.
AU  - Lausevic, Z.
AU  - Cvetković, D.
AU  - Maravic, M.
AU  - Milovanović, Branislav
AU  - Stojakovic, N.
AU  - Tripkovic, I.
AU  - Mihajlovic, D.
AU  - Nestorović, M.
AU  - Pecic, V.
AU  - Petrović, D.
AU  - Stanojevic, G.
AU  - Barisic, G.
AU  - Dimitrijevic, I.
AU  - Krivokapic, Z.
AU  - Markovic, V.
AU  - Popović, Milan
AU  - Aleksić, A.
AU  - Dabic, D.
AU  - Kostic, I.
AU  - Milojkovic, A.
AU  - Perunicic, V.
AU  - Lukić, Dejan
AU  - Petrović, T.
AU  - Radovanovic, D.
AU  - Radovanovic, Z.
AU  - Cuk, V. M.
AU  - Cuk, V. V.
AU  - Kenic, M.
AU  - Kovacevic, B.
AU  - Krdzic, I.
PY  - 2017
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/1667
AB  - Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4% (n = 2515) underwent surgery for malignancy and 11.7% (n = 375) underwent surgery for Crohns disease. An anastomosis was performed in 94.8% (n = 3041) of patients, which was handsewn in 38.9% (n = 1183) and stapled in 61.1% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe.
T2  - Colorectal Disease
T1  - Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit
VL  - 19
IS  - 8
SP  - O296
EP  - O311
DO  - 10.1111/codi.13646
ER  - 

@article{
author = "Pinkney, T. and Gvozdenović, M. and Jovanović, Dragana J. and Lausevic, Z. and Cvetković, D. and Maravic, M. and Milovanović, Branislav and Stojakovic, N. and Tripkovic, I. and Mihajlovic, D. and Nestorović, M. and Pecic, V. and Petrović, D. and Stanojevic, G. and Barisic, G. and Dimitrijevic, I. and Krivokapic, Z. and Markovic, V. and Popović, Milan and Aleksić, A. and Dabic, D. and Kostic, I. and Milojkovic, A. and Perunicic, V. and Lukić, Dejan and Petrović, T. and Radovanovic, D. and Radovanovic, Z. and Cuk, V. M. and Cuk, V. V. and Kenic, M. and Kovacevic, B. and Krdzic, I.",
year = "2017",
abstract = "Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4% (n = 2515) underwent surgery for malignancy and 11.7% (n = 375) underwent surgery for Crohns disease. An anastomosis was performed in 94.8% (n = 3041) of patients, which was handsewn in 38.9% (n = 1183) and stapled in 61.1% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe.",
journal = "Colorectal Disease",
title = "Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit",
volume = "19",
number = "8",
pages = "O296-O311",
doi = "10.1111/codi.13646"
}

Pinkney, T., Gvozdenović, M., Jovanović, D. J., Lausevic, Z., Cvetković, D., Maravic, M., Milovanović, B., Stojakovic, N., Tripkovic, I., Mihajlovic, D., Nestorović, M., Pecic, V., Petrović, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popović, M., Aleksić, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukić, D., Petrović, T., Radovanovic, D., Radovanovic, Z., Cuk, V. M., Cuk, V. V., Kenic, M., Kovacevic, B.,& Krdzic, I.. (2017). Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit. in Colorectal Disease, 19(8), O296-O311.
https://doi.org/10.1111/codi.13646

Pinkney T, Gvozdenović M, Jovanović DJ, Lausevic Z, Cvetković D, Maravic M, Milovanović B, Stojakovic N, Tripkovic I, Mihajlovic D, Nestorović M, Pecic V, Petrović D, Stanojevic G, Barisic G, Dimitrijevic I, Krivokapic Z, Markovic V, Popović M, Aleksić A, Dabic D, Kostic I, Milojkovic A, Perunicic V, Lukić D, Petrović T, Radovanovic D, Radovanovic Z, Cuk VM, Cuk VV, Kenic M, Kovacevic B, Krdzic I. Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit. in Colorectal Disease. 2017;19(8):O296-O311.
doi:10.1111/codi.13646 .

Pinkney, T., Gvozdenović, M., Jovanović, Dragana J., Lausevic, Z., Cvetković, D., Maravic, M., Milovanović, Branislav, Stojakovic, N., Tripkovic, I., Mihajlovic, D., Nestorović, M., Pecic, V., Petrović, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popović, Milan, Aleksić, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukić, Dejan, Petrović, T., Radovanovic, D., Radovanovic, Z., Cuk, V. M., Cuk, V. V., Kenic, M., Kovacevic, B., Krdzic, I., "Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit" in Colorectal Disease, 19, no. 8 (2017):O296-O311,
https://doi.org/10.1111/codi.13646 . .