Prognostic Factors Analysis for Colon Cancer with Lymph Node Negative.

PURPOSE: The analysis of high risk relapse prognosis factors and their importance regarding recurrence risk for stage I and II colon cancer, according to TNM classification 8th edition, 2017. MATERIAL AND METHOD: We performed a retrospective analysis regarding the impact of prognosis factors for patients with high recurrence risk in stages I and II. We studied 99 patients with T2, T3 and T4 tumors who suffered a curative resection and whom may or may not present indication for adjuvant chemotherapy according to histoprognostic factors and molecular biomarkers. Results: We performed a univariate Cox regression which highlighted that male sex is a risk factor for disease relapse (HR=5.53, p 0.05, IC95% = 1.29 to 23.73). Although with a low statistical significance effect, T4 tumors seems to be associated with a poor prognosis regarding disease relapse (HR = 2.56, p = 0.06, IC95% = 0.94 to 6.99) compared to T2 and T3 tumors. Patients with d'MMR (MSI-H) seem to have a more favorable evolution compared to patients with p'MMR (MSS/MSI-L) - HR (d'MMR vs p'MMR) = 0.19, IC95% = 0.02 to 1.61, p = 0.13. Conclusions: We believe that it would be useful for MSS / MSI to be systematically analyzed, our data suggesting a better response of d`MMR patients to adjuvant chemotherapy. The multivariate Cox regression did not identify independent risk factors of relapse.

Single Port Right Colectomy: Surgical Technique.

The single port laparoscopic method was first used in 1999 by Bresadola for cholecystectomy. Nearly a decade later, in 2008, the first single port right hemicolectomy was reported by Bucher and others in a case involving an ascending colon polyp (1,2). The continuous technological evolutional lows the first single port right hemicolectomy 17 years after the first laparoscopic hemicolectomy (1991) which was initially met with reluctance and after has gained a well-established place in the range of colorectal surgery (2). Single port access, as well as NOTES, provides, in comparison with the standard laparoscopic procedure, the aesthetic benefit, the decrease of postoperative pain and a shorter duration of hospitalization, while in terms of disadvantages, we could mention a longer surgery duration due to fewer opportunities of triangulation and vision (3,4). The reduction of postoperative pain plus the good aesthetic results with no significant increase of postoperative complications, already proved by retrospective studies, require confirmation by randomized studies envisaged by trial TRUE in France (5). Single port right hemicolectomy can be achieved with oncologic results similar to standard laparoscopic surgery, having very good postoperative results in terms of aesthetics and reduced postoperative pain (5,6,7).

Holoprosencephaly: two case reports.

Holoprosencephaly is a rare malformation encountered in newborns. It refers to the absent or incomplete division of the prosencephalon.Case no. 1: a fetus was diagnosed by ultrasonogram at 29 weeks of gestation with alobar holoprosencephaly, proboscis and cyclopia. The premature infant was delivered by cesarean section at 32 weeks of gestation, confirming antenatal diagnosis.Case no. 2: a premature newborn at 29 weeks of gestation, who presented posterior pole of cranial cavity occupied by a translucent, asymmetrically disposed structure, with anatomically normal cerebellum, compressing the posterior horn of the left cerebral hemisphere. Lateral ventricles, had also a large communication in their middle with incomplete fused thalami. The diagnosis of lobar holoprosencephaly with arachnoid cyst was confirmed by the autopsy.