MARCELO SIMAS DE LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Long-term results of an endoscopic screening program for superficial esophageal cancer in patients with head and neck squamous cell carcinoma(2022) MOURA, Renata Nobre; KUBOKI, Yeda; BABA, Elisa Ryoka; SAFATLE-RIBEIRO, Adriana; MARTINS, Bruno; PAULO, Gustavo Andrade de; TOLENTINO, Luciano Lenz; LIMA, Marcelo Simas de; KULCSAR, Marco Aurelio; SALLUM, Rubens Antonio Aissar; JR, Ulysses Ribeiro; MALUF-FILHO, FauzeBackground and study aims Patients with head and neck squamous cell carcinoma (HNSCC) are at risk of a second primary tumor in the gastrointestinal tract, most commonly in the esophagus. Screening these patients for esophageal carcinoma may help detect asymptomatic dysplasia and early cancer, thus allowing curative treatment and more prolonged survival, but the impact of endoscopic screening remains uncertain. Here we aimed to describe the long-term results of an esophageal SCC screening program in patients with head and neck cancer in terms of prevalence, associated risk factors, and survival. Patients and methods We performed an observational study of a prospectively collected database including patients with HNSCC who had undergone high-definition endoscopy with chromoscopy between 2010 and 2018 at a Brazilian tertiary academic center. Results The study included 1,888 patients. The esophageal SCC prevalence was 7.9 %, with the majority (77.8 %) being superficial lesions. Significant risk factors for esophageal high-grade dysplasia (HGD) and invasive cancer included tumors of the oral cavity and oropharynx and the presence of low-grade dysplasia (LGD). Overall survival (OS) was significantly shorter among patients in whom esophageal cancer was diagnosed at an advanced stage (P < .001). OS did not significantly differ between patients with HGD and early esophageal cancer versus those without esophageal cancer (P = .210) Conclusions Endoscopic screening for superficial esophageal neoplasia in patients with HNSCC improves esophageal cancer detection. Screening could potentially benefit patients with primary cancer located at the oropharynx or oral cavity. In addition, the detection of esophageal LGD indicates a need for endoscopic surveillance.
conferenceObject THE ROLE OF PROBE-BASED CONFOCAL ENDOMICROSCOPY (PCLE) IN THE DIAGNOSIS OF SUSTAINED CLINICAL COMPLETE RESPONSE UNDER WATCH-AND-WAIT STRATEGY AFTER NEOADJUVANT CHEMORADIOTHERAPY FOR LOCALLY ADVANCED RECTAL ADENOCARCINOMA(2022) SAFATLE-RIBEIRO, Adriana V.; LATA, John; FERREIRA, Marina Tucci Gammaro Baldavira; FLOR, Marcelo M.; PEREZ, Caio; BABA, Elisa R.; LENZ, Luciano H.; MARTINS, Bruno Da Costa; KAWAGUTI, Fabio S.; PAULO, Gustavo A. De; LIMA, Marcelo S. De; MOURA, Renata N.; PENNACCHI, Caterina; GUSMON, Carla; GEIGER, Sebastian; UEMURA, Ricardo; NAHAS, Caio Sergio R.; MARQUES, Carlos F.; IMPERIALE, Antonio R.; COTTI, Guilherme C.; RIBEIRO, Ulysses; MALUF-FILHO, Fauze; NAHAS, Sergio C.- Tube-in-tube endoscopic vacuum therapy for the closure o upper gastrointestinal fistulas, leaks, and perforations(2022) LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; GUSMON-OLIVEIRA, Carla Cristina; POMBO, Amanda Aquino de Miranda; MARTINS, Bruno Costa; LENZ, Luciano; KAWAGUTI, Fabio Shiguehissa; PAULO, Gustavo Andrade De; BABA, Elisa Ryoka; V, Adriana Safatle-Ribeiro; RIBEIRO, Ulysses; MONKEMULLER, Klaus; MALUF-FILHO, FauzeBackground Although endoscopic vacuum therapy (EVT) has been successfully used to treat postoperative upper gastrointestinal (UGI) wall defects, its use demands special materials and several endoscopic treatment sessions. Herein, we propose a technical modification of EVT using a double tube (tube-in-tube drain) without polyurethane sponges for the drainage element. The tube-in-tube drainage device enables irrigation and application of suction. A flowchart for standardizing the management of postoperative UGI wall defects with this device is presented. Methods An EVT modification was made to achieve frequent fistula cleansing, with 3% hydrogen peroxide rinsing, and the application of negative pressure. A tube-in-tube drain without polyurethane sponges can be inserted like a nasogastric tube or passed through a previously positioned surgical drain. This was a retrospective two-center observational study, with data collected from 30 consecutive patients. Technical success, clinical success, adverse events, time under therapy, interval time from procedure to fistula diagnosis and treatment start, size of transmural defect, volume of cavity, number of endoscopic treatment sessions, and mortality were reviewed. Results 30 patients with UGI wall defects were treated. The technical and clinical success rates were 100% and 86.7%, respectively. Three patients (10%) had adverse events and three patients (10%) died. The median time under therapy was of 19 days (range 1-70) and the median number of endoscopic sessions was 3 (range 1-9). Conclusions This standardized approach and EVT modification using a tube-in-tube drain, with frequent fistula cleansing, were successful and safe in a wide variety of UGI wall defects.
- Endoscopic treatment of rectovesical fistula after colorectal anastomosis: tube-in-tube endoscopic vacuum therapy method(2022) LIMA, Marcelo Simas de; PEREZ, Caio Almeida; GUACHO, John Alexander Lata; FLOR, Marcelo Mochate; TUCCI, Marina; FERREIRA, Marina; MALUF-FILHO, Fauze
- Top tips on endoscopic vacuum therapy (with video)(2022) LIMA, Marcelo Simas de
- TC-325 hemostatic powder in the management of upper gastrointestinal malignant bleeding: a randomized controlled trial(2022) MARTINS, Bruno Costa; MACHADO, Andressa Abnader; SCOMPARIN, Rodrigo Corsato; PAULO, Gustavo Andrade; SAFATLE-RIBEIRO, Adriana; GEIGER, Sebastian Naschold; LENZ, Luciano; LIMA, Marcelo Simas; PENNACCHI, Caterina; RIBEIRO, Ulysses; BARKUN, Alan N.; MALUF-FILHO, FauzeBackground and study aims Upper gastrointestinal bleeding (UGIB) from malignancy is associated with high rebleeding and mortality rates. Recently, TC-325 powder has shown promising results in the treatment of UGIB, including malignant bleeding. The aim of this study was to compare the efficacy of TC-325 versus best clinical management. Patients and methods From August 2016 to February 2020, all patients with evidence of UGIB from malignancy were randomized to receive TC-325 therapy or control group, in which endoscopic treatment was not mandatory. Exclusion criteria were hemoglobin drop without overt bleeding and UGIB from non-tumor origin. The primary outcome was 30-day mortality. Secondary outcomes were 30-day rebleeding, blood transfusion and length of hospital stay. Results Sixty-two patients were randomized, three were excluded and 59 were included in the final analysis (TC-325 group = 28; control = 31). Groups were similar at baseline. Active bleeding was observed in 22 patients in the TC-325 group and 19 in the control group (P=0.15). Successful initial hemostasis with TC-325 was achieved in all cases. Additional therapy (radiotherapy, surgery or arterial embolization) was equally performed in both groups (42.9% vs 58.1 %; P=0.243). There were no differences in 30-day mortality (28.6% vs. 19.4%, P=0.406) or 30-day rebleeding rates (32.1 % vs. 19.4%, P=0.26). Logistic regression identified no significant predictors of rebleeding. Age, Eastern Cooperative Oncology Group (ECOG) score 3 to 4 and AIMS65 score > 1 predicted greater mortality. Conclusions TC-325 was effective in achieving immediate hemostasis in malignant gastrointestinal bleeding but did not reduce 30-day mortality, 30-day rebleeding, blood transfusion or length of hospital stay. Age, ECOG 3-4, and AIMS65 > 1 were predictive factors of mortality.