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Objective/background: Various anastomotic and reconstruction techniques are used for minimally invasive total (miTG) and distal gastrectomy (miDG). Their effects on postoperative morbidity have not been extensively studied., Methods: MiTG and miDG patients were selected from 9356 oncological gastrectomies performed in 2017-2021 in 43 centers. Endpoints included anastomotic leakage (AL) rate and postoperative morbidity tested by multivariable analysis., Results: Three major anastomotic techniques [circular stapled (CS); linear stapled (LS); and hand sewn (HS)], and 3 major bowel reconstruction types [Roux (RX); Billroth I (BI); Billroth II (BII)] were identified in miTG (n=878) and miDG (n=3334). Postoperative complications, including AL (5.2% vs 1.1%), overall (28.7% vs 16.3%), and major morbidity (15.7% vs 8.2%), as well as 90-day mortality (1.6% vs 0.5%) were higher after miTG compared with miDG. After miTG, the AL rate was higher after CS (4.3%) and HS (7.9%) compared with LS (3.4%). Similarly, major complications (LS: 9.7%, CS: 16.2%, and HS: 12.7%) were lowest after LS. Multivariate analysis confirmed anastomotic technique as a predictive factor for AL, overall, and major complications. In miDG, AL rate (BI: 1.4%, BII 0.8%, and RX 1.2%), overall (BI: 14.5%, BII: 15.0%, and RX: 18.7%), and major morbidity (BI: 7.9%, BII: 9.1%, and RX: 7.2%), and mortality (BI: 0%, BII: 0.1%, and RY: 1.1%%) were not affected by bowel reconstruction., Conclusions: In oncologically suitable situations, miDG should be preferred to miTG, as postoperative morbidity is significantly lower. LS should be a preferred anastomotic technique for miTG in Western Centers. Conversely, bowel reconstruction in DG may be chosen according to the surgeon's preference., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

In personnel monitoring, operational quantities recommended by ICRU Publication No. 39 for photon radiation can be realized by calibrating dosimeters on a phantom and considering body backscatter photons by using established conversion factors. Personnel dosimeters used in this study are based on CaSO4:Dy Teflon thermoluminescence dosimeter discs (TLD) that have a highly photon energy-dependent response. Since body backscattered photons have lower energies than the incidence photons, methods for correcting for energy dependence of both the incident and body backscattered photons have to be developed. By using readouts of two TLD discs (one under a composite metal filter and the other without a metal filter) in an empirical relation valid at all energies, it is possible to correct for the effect of change in response from change in the photon energies. It was found that the new operational quantities recommended by ICRU could be estimated to within +/- 15% by a TLD badge design based on this method. Angular dependence limits for photons in accordance with the new international standards and a high beta dose-equivalent discrimination in the mixed fields of beta and low-energy x rays could also be achieved.