SERGIO CARLOS NAHAS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
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conferenceObject OUTCOMES OF PATIENTS WITH LOCAL REGROWTH AFTER NONOPERATIVE MANAGEMENT OF RECTAL CANCER AFTER NEOADJUVANT CHEMORADIOTHERAPY.(2020) COTTI, G. C.; PANDINI, R. V.; BRAGHIROLI, O. F.; NAHAS, C. R.; MARQUES, C. F. Sparapan; IMPERIALE, A. Rocco; BUSTAMANTE-LOPEZ, L. A.; RIBEIRO, U.; SALVAJOLI, B.; HOFF, P.; NAHAS, S. C.- Outcomes of Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects(2017) COLTRO, Pedro S.; BUSNARDO, Fabio F.; MONACO FILHO, Franklin C.; OLIVAN, Marcelo V.; MILLAN, Lincoln S.; GRILLO, Victor A.; MARQUES, Carlos F.; NAHAS, Caio S.; NAHAS, Sergio C.; RIBEIRO JR., Ulysses; GEMPERLI, RolfBACKGROUND: There are many previous reports for using the internal pudendal artery perforator flap in vulvovaginal reconstruction; however, reports of this flap for perineal reconstruction after abdominoperineal excision of the rectum are scarce. OBJECTIVE: The purpose of this study was to evaluate the outcomes of immediate internal pudendal artery perforator flap reconstruction for irradiated abdominoperineal resection defects. DESIGN: This was a prospective case series. SETTINGS: This flap could represent a step forward over other perineal flap approaches or primary closure. PATIENTS: A total of 73 consecutive patients with anorectal tumors were included. INTERVENTIONS: The study included immediate perineal reconstruction using 122 internal pudendal artery perforator flaps after abdominoperineal excision of the rectum. MAIN OUTCOME MEASURES: Dimensions of the perineal defect (in centimeters squared), hospital stay (days), healing time (days), and postoperative complications (Clavien-Dindo grades) were measured. RESULTS: The means of the perineal defect, hospital stay, and healing time were 51.62 cm(2), 15.94 days, and 38.52 days. The higher the patient BMI, the longer healing time (p = 0.02); Clavien-Dindo complications grades III to IV were greater in patients with perineal defect >= 60 cm(2) (p = 0.03; OR = 10.56); postoperative complications were higher both in patients with anal squamous cell carcinoma (p = 0.005; OR = 6.09) and in patients with comorbidities (p = 0.04; OR = 2.78); hospital stay (p = 0.001) and healing time (p < 0.001) were higher in patients who had postoperative complications. The complete perineal wound healing at 12 weeks was achieved by 95% of patients, and our 30-day mortality rate was 4%. LIMITATIONS: As a nonrandomized study, our results have to be interpreted with caution. CONCLUSIONS: Multiple previously described advantages associated with internal pudendal artery perforator flap were also observed here, reinforcing the idea that it is reliable, versatile, and a useful option for perineal reconstruction after abdominoperineal excision of the rectum. Therefore, we propose that this flap could be considered as the first choice for perineal reconstruction in selected patients with moderate and some large defects after abdominoperineal excision of the rectum. See Video Abstract at http://links.lww.com/DCR/A367.
conferenceObject MINIMALLY INVASIVE PELVIC LATERAL LYMPHADENECTOMY IN LOCALLY ADVANCED RECTAL CANCER AFTER NEOADJUVANT TREATMENT.(2022) COTTI, G.; BUSTAMANTE-LOPEZ, L.; NAHAS, C. S.; MARQUES, C. F.; IMPERIALE, A.; BRAGHIROLI, O.; HORVAT, N.; SOBRADO, L. F.; AVERBACH, P.; CIRENZA, C.; NAHAS, S. C.conferenceObject POSTOPERATIVE TEM COMPLICATIONS FOR THE TREATMENT OF RECTAL NEOPLASIA ARE FREQUENT BUT MILD. RISK FACTORS AND TIME BEHAVIOR STUDY(2014) MARQUES, C.; NAHAS, C.; RIBEIRO, U.; BUSTAMANTE, L.; PINTO, R.; MORY, E.; CECCONELLO, I.; NAHAS, S.- Suture Rectopexy and Repair of the Pouch of Douglas for Rectal Intussusception and Enterocele(2022) SOBRADO, Lucas Faraco; NAHAS, Sergio Carlos; SOBRADO, Carlos Walter
conferenceObject THE EVOLUTION OF COLORECTAL SURGERY LAPAROSCOPY IN A TEACHING INSTITUTION.(2017) GERBASI, L.; CAMARGO, M.; PINTO, R.; KIMURA, C.; SOARES, D.; NAHAS, S.; CECCONELLO, I.conferenceObject LAPAROSCOPIC RIGHT COLECTOMY WITH EXTRACORPOREAL ANASTOMOSIS HAS HIGHER MORBIDITY COMPARED TO INTRACORPOREAL ANASTOMOSIS?(2017) PINTO, R.; GERBASI, L.; CAMARGO, M.; KIMURA, C.; SOARES, D.; BUSTAMANTE-LOPEZ, L.; NAHAS, C.; CAMPOS, F.; CECCONELLO, I.; NAHAS, S.- Lymph Node Yield After Neoadjuvant Chemoradiotherapy in Rectal Cancer Specimens: A Randomized Trial Comparing Two Fixatives(2018) DIAS, Andre R.; PEREIRA, Marina Alessandra; MELLO, Evandro Sobroza de; NAHAS, Sergio Carlos; CECCONELLO, Ivan; RIBEIRO JR., UlyssesBACKGROUND: It is widely reported that neoadjuvant chemoradiation reduces lymph node yield in rectal cancer specimens. Some have questioned the adequacy of finding 12 lymph nodes for accurate staging, and fewer nodes were correlated with good response. Others reported that low lymph node count raises the chance for understaging and correlates with worse survival. In addition, a few studies demonstrated that diligent specimen analysis increases lymph node count. OBJECTIVE: The aim of this study was to compare Carnoy's solution and formalin concerning lymph node yield in specimens of patients with rectal cancer after neoadjuvant chemoradiation. DESIGN: This is a prospective randomized trial that was conducted from 2012 to 2015. SETTINGS: This study was performed in a reference cancer center in Brazil. PATIENTS: Patients who underwent low anterior resection with total mesorectal excision after neoadjuvant chemoradiation for rectal adenocarcinoma were included. INTERVENTION: Rectosigmoid specimens were randomized for fixation with Carnoy's solution or formalin. MAIN OUTCOME MEASURES: A total of 130 specimens were randomized. After dissection, the residual fat from the formalin group was immersed in Carnoy's solution in search for missed lymph nodes (Revision). RESULTS: The Carnoy's solution group had superior lymph node count (24.0 vs 16.3, p < 0.01) and fewer cases with <12 lymph nodes (6 vs 22, p = 0.001). The Revision group found lymph nodes in all cases (mean, 11.1), retrieving metastatic lymph nodes in 6 patients. It reduced the formalin cases with <12 lymph nodes from 33.8% to 4.6% and upstaged 2 patients. Tumor response to neoadjuvant chemoradiotherapy was not associated with lymph node count. LIMITATIONS: This was a unicentric study. CONCLUSIONS: Compared with formalin, the Carnoy's solution increases lymph node count and reduces the cases with <12 lymph nodes. Harvested lymph nodes are missed following routine analysis and this is clinically relevant. Finding <12 lymph nodes is not a sign of good response to neoadjuvant chemoradiation (www.clinicaltrials.gov. Unique identifier: NCT02629315). See Video Abstract at http://links.lww.com/DCR/A694.
conferenceObject SALVAGE SURGICAL TREATMENT IN PATIENTS WITH PERSISTENT OR RECURRENT ANAL SQUAMOUS CELL CARCINOMA AFTER CHEMOTHERAPY AND RADIOTHERAPY TREATMENT.(2020) PAIVA, A. C.; NAHAS, C. R.; KIMURA, C. M.; RIBEIRO, U.; NAHAS, S. C.; CECCONELO, I.; MARQUES, C. S.conferenceObject EFFICACY OF TRIDIMENSIONAL ENDORECTAL ULTRASOUND IN COMPARISON TO HISTOPATHOLOGY FOR EVALUATION EXTRA PERITONEAL RECTAL NEOPLASMS.(2015) PINTO, R.; CORREA NETO, I.; NAHAS, S.; NAHAS, C.; MARQUES, C.; RIBEIRO JUNIOR, U.; BUSTAMANTE-LOPEZ, L.; SOARES, D.; CECCONELLO, I.