PURPOSE: To investigate de adjunctive effect of Hyperbaric Oxygen Therapy in a group of patients with refractory Crohn's disease.

PURPOSE: This paper describes the ability of miRNA value predict oncological outcomes in CRC patients and correlates to clinical and pathologic variables. METHODS:We prospectively analyzed the serological expression of microRNA-21, microRNA-34a, and microRNA-126 in 37 stage II -IV CRC patients and correlate to seven fit counterparts. Serological microRNAs were extracted using the miRNeasy Mini Kit® (Qiagen, Hilden, Germany). Quantification of microRNAs was performed using TaqMan Master Mix® reagent (Applied Biosystems, USA). RESULTS:We obtained serological underexpression microRNA-21, microRNA-34a, and microRNA-126 in CRC group. However, miRNAs serological values do not impact prognosis. Furthermore, miRNAs was not influenced by CEA values, TNM staging, and histological subtype. CONCLUSION:Despite lower expression of miR-21, miR-34a and miR-126 in the CRC group, no association with poor prognosis was found.

PURPOSE:In this paper we report clinical variables on colon cancer series. Oncological outcomes were compared to low-income and high-income countries. METHODS:We analysed a prospective database of 51 colon cancer patients submitted to primary tumor resection between 2010 and 2011, showing clinical variables and oncologic outcomes.RESULTS: R0 resection obtained in 80.4%, 21.6% of patients was TNM stage IV, and only 13.7% showed TNM stage I. Diseasefree survival was 32 months, overall survival was 46 months, and the tumoral recurrence rate was 9.8%. Univariate analysis showed association of serum CEA levels ≥ 5 ng/dl (p= 0.004), presence of metastasis at diagnosis (p= 0.012), compromised surgical margins (p < 0.001) and poorer tumor differentiation (p= 0.041) to death. Multivariate analysis identified compromised surgical margins as an independent risk factor for death due to colon cancer (P=0.003; odds ratio=0.36; 95% confidence interval=0.004-0.33). Nowadays, 62.7% of patients are alive. CONCLUSION:Recurrence rate, disease-free survival and overall survival was similar to those observed in more developed countries.Serum CEA levels ≥ 5 ng/dl, the presence of metastasis at diagnosis, compromised surgical margins and poorer tumor differentiation were associated with death. A compromised surgical margin was the only independent risk factor for death.

PURPOSE:In this paper we report the oncological outcomes from clinical series of patients with rectal cancer submitted to local excision after neoadjuvant therapy and discuss the indications for local excision in partial clinical responders. METHODS:We analysed a prospective database of 39 patients submitted to a transanal endoscopic operation for rectal cancer after neoadjuvant chemoradiation between 2006 and 2015, comparing clinical and pathological variables, perioperative complications, recurrence rate and overall survival. RESULTS:We obtained 15.4% ypT0, 17.9% ypT1, 35.9% ypT2 and 28.2% ypT3. After a median follow-up of 24 months, tumoral recurrence was observed in 4 patients, one of them with isolated pulmonary metastasis. R0 resection was achieved in 79.5%, and postoperative complications were observed in 30.2% patients and no perioperative mortality occur. Compromise surgical margins do not affect recurrence rate, and 94.9% of patients are alive nowadays. CONCLUSION:Local excision could be associated with low recurrence rate and good overall survival. Short hospitalization time and low level of serious complications observed could be an interesting option for patients who would not tolerate a radical procedure or for those who declined a total mesorectal excision. A strict long-term follow-up must be warranted to detect early tumoral recurrence.

ResumoO pleno conhecimento da anatomia vascular torácica é de suma importância para os profissionais envolvidos na realização de procedimentos invasivos como a punção de acesso venoso central. A persistência da veia cava superior esquerda é a malformação venosa torácica mais frequente, e seu diagnóstico costuma ser incidental. Apresentamos o caso de uma paciente de 14 anos em que o diagnóstico de veia cava superior esquerda persistente foi incidental em exame de imagem de controle após colocação de cateter venoso totalmente implantável. A paciente não apresentou dificuldade de infusão de quimioterapia pelo cateter e não houve complicações relacionadas ao cateter.

Agradeço primeiramente a Deus, por até aqui ter nos conduzido com vida e saúde. Agradeço também: à minha mãe, Sineid, que com seu jeito doce e amoroso conseguiu me mostrar a importância de estudar. ao meu pai, José Roberto, pelo exemplo de retidão, seriedade e compromisso com a família. à Branca, que com seu carinho e companheirismo desde os tempos de namoro me tornou uma pessoa melhor, sempre me motivando e me apoiando com seu amor incondicional. à Helena, que me mostrou que o amor não tem limites...te amo muito filha!! ao meu irmão, Paulo, meu melhor amigo e conselheiro, por dividir comigo todos os ensinamentos que a vida arduamente oferece. ao Padrinho Sinval e à Madrinha Alceny, por me ensinarem os dons do perdão e do acolhimento. à vovó Terezinha, sempre querida, que cuidou de mim com todo o amor e carinho, e que ainda cuida através de suas orações. à tia Bete, ao Tio Deco, ao Mário Broetto, ao Pignaton, ao Almir, ao Cesário, ao Dal´Col e ao Edu, que me acolheram e me ampararam quando eu mais precisei. à D. Angélica, ao Sr. Geoffrey, à Camila, à Carol e ao João, que me ajudaram e incentivaram. ao saudoso Professor Roberto Gomes, que foi como um pai para mim dentro da Medicina...que Deus o proteja onde estiver Professor!! Palavras-chave: Neoplasias do sistema digestório. Neoplasias do cólon. Sobrevida. Prognóstico. MicroRNA.

PURPOSE:To describe a novel securing device for loop colostomies, developed in our institution and report our 10-year experience. METHODS:The T-shaped support device was used in all patients who required loop colostomy and who were at an increased risk of stoma withdrawal. The device was removed on the fifth postoperative day in all patients. An analysis from a prospective database regarding early postoperative complication, from 209 patients, was conducted between 2003 and 2013. RESULTS:Bleeding, peristomal skin problems, surgical site infection, stomal ischemia/necrosis, stenosis, obstruction, retraction and early withdrawal of the stoma were not noted in all cases. Thirteen patients (6%) reported mild discomfort on the site of the skin suture.Removal of the instrument was fast and easy, with the advantage of keeping the colostomy bag. CONCLUSION:The T-shaped bridge device successfully prevented stoma withdrawal in all subjects. The device was safe and well accepted, with minor complications.

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