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Breast cancer is a heterogeneous disorder for which the underlying genetic basis remains unclear. The current study was conducted to evaluate the possible association between trinucleotide-repeatcontaining 9 (TNRC9) genetic variants and breast cancer risk in Egyptian women. Genotyping of the rs12443621 polymorphism of the TNRC9 gene by real time PCR (RT-PCR) on 100 female breast cancer patients and 80 healthy female controls was done. Breast cancer patients have significantly decreased age at menarche compared to control. Breast feeding and parity are associated with reduced breast cancer risk. The homozygous GG genotype and G allele were more frequent in the breast cancer group than in control subjects. The GG genotype frequency was associated with 2.8 times higher risk of breast cancer than AA genotype, also the G allele was associated with 1.9 times higher risk of breast cancer than A allele. The distribution of the TNRC9 rs12443621 polymorphism was significantly associated with both estrogen and progesterone receptor status. The combined AG and GG genotypes were not significantly associated with the presence of metastasis and Her 2 /neu status (P=0.89 and 0.49, respectively). From this study, it could be concluded that, a significant association was found between the GG genotype of TNRC9 rs12443621 and elevated breast cancer risk and signifies the TNRC9 rs12443621 G allele as being a potential risk factor for breast cancer. Further larger population-based studies are needed to confirm the prognostic value of this polymorphism in Egyptian women.Manal A Safan1 and Alaa A El-Sisi2 ‫ـــــــــــــــــــــــــــــــــــــــــــــــ‬ ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ ‫ـــــــــ‬ 40

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Background: Colorectal cancer is considered the 3rd common malignancy worldwide responsible for 9% of all cancer incidence. Currently laparoscopy is widely practiced in colorectal cancer surgery. It is related to the surgeon's experience to do either lateral-to-medial or medial-to-lateral approach. The two laparoscopic approaches are currently practiced and there are conflicts of superiority of this over that and vice versa. We aimed to show the superiority of one procedure over the other regarding short-term outcomes.Patient and Methods: This is a prospective randomized study of laparoscopic colorectal surgery. One hundred patients were included in this study.Patients were divided to 2 equal groups medial to lateral (M-L) and lateral to medial group (L-M), 50 patients each. The study was conducted from Feb 2017 to May 2021 in Menoufia university hospital, in the general surgery department.The study endpoint was: The feasibility, technical efficacy, operative time, vascular or ureteric injury and other complications of both techniques. We collected data according to patient demographics, technique of laparoscopic mobilization, surgery duration, hospital stay, operative and post-operative complications and lymph node retrieval.Results: One hundred patients with comparable demographics criteria had laparoscopic colorectal cancer surgery. Sixty-one patients were males (61%) and 39 patients (39%) were females. Fifty patients (50 %) were performed using M-L technique and the other 50 patients (50.0%) were operated upon using the L-M approach. Lateral approach had an average 10±3 (4–22) lymph nodes with specimen compared to 17±4 (9–31) in the medial approach. There was no statistically significant difference in the major complication rate (Clavien-Dindo IV) between the two approaches. M-L approach showed significant shorter operative time than L-M approach in anterior resection and Rt hemicolectomy in favor of M-L approach p<0.05. L-M approach showed a significant higher rate of conversion to open surgery and injury to the ureter and gonadal vessels. p<0.05. Patients in the M-L approach had a mean hospital stay of 5±1 days (range 3–52) compared to 5± 2 days (range 3–56) in the L-M approach. P >0.05Conclusion: Both approaches were feasible for colon cancer surgery. Laparoscopic M-L approach was found technically easier, and had less surgery related complications than the L-M approach.

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