MARCELO SIMAS DE LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
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- Etiology, endoscopic management and mortality of upper gastrointestinal bleeding in patients with cancer(2013) MALUF-FILHO, Fauze; MARTINS, Bruno da Costa; LIMA, Marcelo Simas de; LEONARDO, Daniel Valdivia; RETES, Felipe Alves; KAWAGUTI, Fabio Shiguehissa; SATO, Cezar Fabiano Manabu; HONDO, Fabio Yuji; SAFATLE-RIBEIRO, Adriana Vaz; RIBEIRO JR., UlyssesBackground: The source and outcomes of upper gastrointestinal bleeding (UGIB) in oncologic patients are poorly investigated. Objective: The study aimed to investigate these issues in a tertiary academic referral center specialized in cancer treatment. Methods: This was a retrospective study including all patients with cancer referred to endoscopy due to UGIB in 2010. Results: UGIB was confirmed in 147 (of 324 patients) referred to endoscopy for a suspected episode of GI bleeding. Tumor was the most common cause of bleeding (N = 35, 23.8%), followed by varices (N = 30, 19.7%), peptic ulcer (N = 29, 16.3%) and gastroduodenal erosions (N = 16, 10.9%). Among the 32 patients with cancer of the upper GI tract, the main causes of bleeding were cancer (N = 27, 84.4%) and peptic ulcer (N = 5, 6.3%). Forty-one patients (27.9%) presented with bleeding from the primary tumor or from a metastatic lesion, and seven received endoscopic therapy, with successful initial hemostasis in six (85.7%). Rebleeding and mortality rates were not different between endoscopically treated (N = 7) and nontreated (N = 34) patients (28.6% vs. 14.7%, p = 0.342; 43.9% vs. 44.1%, p = 0.677). Median survival was 20 days, and the overall 30-day mortality rate was 44.9%. There was no predictive factor of mortality or rebleeding. Conclusion: Tumor bleeding is the most common cause of UGIB in cancer patients. UGIB in cancer patients correlates with a high mortality rate regardless of the bleeding source. Current endoscopic treatments may not be effective in preventing rebleeding or improving survival.
- Esophageal metallic stent fixation with dental floss: a simple method to prevent migration(2013) MARTINS, B. da Costa; MEDRADO, B. F.; LIMA, M. S. de; RETES, F. A.; KAWAGUTI, F. S.; PENNACCHI, C. M. P. S.; MALUF-FILHO, F.