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t rans-oral robotic surgery for tongue cancer background: The traditional treatment of oropharyngeal cancer was based mainly in radio and che motherapy, aiming to avoid organ excisions. However, the adverse effects of these therapies prompted the development of new therapies. Among these, trans-oral robotic surgery (TORS) has promising results. case reports: We report two patients operated using this technique. An 82 years old woman treated for a tumor in the base of the tongue six years ago with radiotherapy. A new lesion in the tongue was found and excised by TORS uneventfully. The pathology report confirmed the complete excision of the malignant lesion. A 57 years old male with a history of palate cancer treated with radiotherapy in 1990. In 2013 a submandibular mass was biopsied confirming the presence of a squamous carcinoma metastasis. During a bilateral suprahyoid dissec tion, a tumor in the base of the tongue was found. In a second intervention the tumor was excised by TORS. The pathology reports tumor free borders but near the lesion. Postoperative radiotherapy was recommended.

The prolongation of average life in the industrialized countries and the definitive demonstration of preventive and therapeutic role of regular physical exercise and sport, have greatly increased the number of middle-aged and older subjects engaged in the regular practice of sports activities, not only for fun or healthy purposes, but also at competitive level. The creation by sports federations of age categories (five years in five years) has strengthened the agonistic nature of the activity. Master athletes compete not only against adversaries of the same age group but even against themselves and the Time flowing inexorably. At the scientific and clinical level, two are the fundamental implications of this phenomenon. The first is the positive effect of a regular and intense performance training, both anaerobic and aerobic power. In the latter, regular and intense training is able to slow down significantly (even 50%) the natural, progressive decline of cardiorespiratory functions observed in healthy sedentary subjects of the same age. The second, the reverse of the medal, is the difficulty encountered by sports physician and cardiologist to correctly interpret the clinical/instrumental features of the Master athlete who undergoes pre-participation screening for competitive sports. It is not always easy to differentiate the physiological, adaptive, changes of a middle-aged and older athlete from the pathological ones, related to cardiovascular disease, typical of aging, such as ischemic heart disease, arrhythmias, hypertension, valvular diseases. These difficulties can only be solved by having an adequate knowledge of the clinical and instrumental manifestations of the Master Athlete’s Heart and individual cardiopathies, and with the careful use of all modern cardiological instrumental investigations. In addition to echocardiography and maximal ECG stress-test (preferably cardio-pulmonary test), the magnetic resonance imaging with Gadolinium, and coronary tomography (TC) are playing a decisive role. [1], Italian Journal of Anatomy and Embryology, Vol. 122, No. 1 (Supplement) 2017

Introducción: El cáncer de orofaringe representa una importante causa de morbimortalidad en la esfera de las patologías de cabeza y cuello en la actualidad. Su tratamiento tradicional por mucho tiempo consideró la conservación de órganos, utilizando mayoritariamente la radio y quimioterapia como herramientas terapéuticas. Los efectos no deseados tanto de las terapias médicas como las quirúrgicas han obligado a desarrollar técnicas nuevas para el manejo de estas enfermedades. Es así que a partir del año 2006 se ha ido desarrollando a nivel mundial la técnica de cirugía robótica transoral (TORS). La morbilidad y resultados oncológicos de este procedimiento hasta ahora se ven alentadores, por lo que se está transformando en una alternativa terapéutica que debemos manejar. Casos clínicos: Se presentan los dos primeros casos a nivel país realizados en esta institución de cánceres de orofaringe tratados con la técnica tradicional y después de largo tiempo recidivados. Se les realizó cirugía resectiva de sus tumores a través de TORS; se describen los resultados de estos procedimientos. Background: The traditional treatment of oropharyngeal cancer was based mainly in radio and chemotherapy, aiming to avoid organ excisions. However, the adverse effects of these therapies prompted the development of new therapies. Among these, trans-oral robotic surgery (TORS) has promising results. Case reports: We report two patients operated using this technique. An 82 years old woman treated for a tumor in the base of the tongue six years ago with radiotherapy. A new lesion in the tongue was found and excised by TORS uneventfully. The pathology report confirmed the complete excision of the malignant lesion. A 57 years old male with a history of palate cancer treated with radiotherapy in 1990. In 2013 a submandibular mass was biopsied confirming the presence of a squamous carcinoma metastasis. During a bilateral suprahyoid dissection, a tumor in the base of the tongue was found. In a second intervention the tumor was excised by TORS. The pathology reports tumor free borders but near the lesion. Postoperative radiotherapy was recommended.