RICARDO SATO UEMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
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bookPart Drenagem biliar e pancreática ecoguiada(2014) ARTIFON, Everson Luiz de Almeida; CHENG, Spencer; UEMURA, Ricardo Sato- Comparison of the pull and introducer percutaneous endoscopic gastrostomy techniques in patients with head and neck cancer(2017) RETES, Felipe A.; KAWAGUTI, Fabio S.; LIMA, Marcelo S. de; MARTINS, Bruno da Costa; UEMURA, Ricardo S.; PAULO, Gustavo A. de; PENNACCHI, Caterina M. P.; GUSMON, Carla; RIBEIRO, Adriana V. S.; BABA, Elisa R.; GEIGER, Sebastian N.; SORBELLO, Mauricio P.; KULCSAR, Marco A.; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground and study aims: Percutaneous endoscopic gastrostomy (PEG) in head and neck cancer (HNC) patients is associated with higher complication and mortality rates when compared to a general patient population. The pull technique is still the preferred technique worldwide but it has some limitations. The aim of this study is to compare the pull and introducer PEG techniques in patients with HNC. Patients and methods: This study is based on a retrospective analysis of a prospectively collected database of 309 patients with HNC who underwent PEG in the Cancer Institute of SAo Paulo. Results: The procedure was performed with the standard endoscope in 205 patients and the introducer technique was used in 137 patients. There was one procedure-related mortality. Age, sex and albumin level were similar in both groups. However in the introducer technique group, patients had a higher tumor stage, a lower Karnofsky status, and presented more frequently with tracheostomy and trismus. Overall, major, minor, immediate and late complications and 30-day mortality rates were similar but the introducer technique group presented more minor bleeding and tube dysfunctions. Conclusion: The push and introducer PEG techniques seem to be both safe and effective but present different complication profiles. The choice of PEG technique in patients with HNC should be made individually.
conferenceObject Validation of Classic and Expanded Criteria for Endoscopic Submucosal Dissection of Early Gastric Cancer: 7 Years of Experience of a Western Tertiary Cancer Center(2017) MENDONCA, Ernesto Q.; OLIVEIRA, Joel F.; RIBEIRO, Maria Sylvia I.; SAFATLE-RIBEIRO, Adriana V.; MARTINS, Bruno da Costa; GUSMON, Carla C.; BABA, Elisa R.; PENNACCHI, Caterina; KAWAGUTI, Fabio S.; LENZ, Luciano; PAULO, Gustavo A. de; SORBELLO, Mauricio; UEMURA, Ricardo S.; GEIGER, Sebastian N.; LIMA, Marcelo S. de; RIBEIRO, Ulysses; MALUF-FILHO, FauzeconferenceObject RANDOMIZED CONTROLLED TRIAL COMPARING UNDERWATER AND CONVENTIONAL ENDOSCOPIC MUCOSAL RESECTION FOR NON-PEDUNCULATED COLORECTAL LESIONS(2022) LENZ, Luciano H.; MARTINS, Bruno; PAULO, Gustavo A. De; KAWAGUTI, Fabio S.; BABA, Elisa R.; UEMURA, Ricardo S.; GUSMON, Carla C.; GEIGER, Sebastian N.; MOURA, Renata N.; PENNACCHI, Caterina; LIMA, Marcelo S. De; SAFATLE-RIBEIRO, Adriana V.; HASHIMOTO, Claudio L.; RIBEIRO, Ulysses; MALUF-FILHO, Fauzearticle Pancreatic Metastasis from Papillary Thyroid Carcinoma: A Case Report(2020) MACHADO, Andressa A.; LENZ, Luciano; DOMINGUES, Regina B.; LIMA, Gustavo R. A.; JOSINO, Iatagan R.; CORDERO, Martin A. C.; V, Adriana Safatle-Ribeiro; MARTINS, Bruno C.; PENNACCHI, Caterina M. P. S.; GUSMON, Carla C.; PAULO, Gustavo A.; LIMA, Marcelo S.; BABA, Elisa R.; KAWAGUTI, Fabio S.; UEMURA, Ricardo S.; MALUF-FILHO, FauzeIntroduction differentiated thyroid carcinoma presents with distant metastasis in 4% of cases, usually occurring in the lungs, bones and thoracic lymph nodes. Pancreatic involvement is extremely rare, with few cases reported in the literature. Case report A 47-years-old female patient presented abdominal pain. She had a history of papillary thyroid carcinoma surgically resected in 2009. After 10 years, computed tomography revealed hepatic lesions suggestive of secondary involvement and a solid mass in the pancreatic head. Endoscopic ultrasound fine-needle aspiration was performed in a heterogeneous hypoechoic mass located at pancreatic head. Cell block with immunohistochemistry was positive for thyroglobulin, suggesting papillary thyroid carcinoma metastasis. The patient still survives at present, treating metastasis with Cabozantinib. Conclusion endoscopic ultrasound fine-needle aspiration is a minimally invasive and accurate method of sampling lesions of the pancreas. In combination with clinical history and immunohistochemistry, can confirm diagnosis and define management.- Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer(2018) GUSMON-OLIVEIRA, Carla Cristina; KUBOKI, Yeda Mayumi; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; MARTINS, Bruno Costa; TOLENTINO, Luciano Lenz; SAFATLE-RIBEIRO, Adriana Vaz; KULCSAR, Marco Aurelio; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground. Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis. Patients and methods. This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks. Results. From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial. Conclusion. The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.
- Balloon enteroscopy-assisted ERCP and cholangioscopy(2016) PAULO, Gustavo Andrade de; BASTOS, Victor Rossi; MARTINS, Bruno da Costa; SAFATLE-RIBEIRO, Adriana Vaz; GUSMON, Carla Cristina; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; MALUF FILHO, Fauze
- Diagnostic accuracy of probe-based confocal laser endomicroscopy in Lugol-unstained esophageal superficial lesions of patients with head and neck cancer(2017) SAFATLE-RIBEIRO, Adriana Vaz; BABA, Elisa Ryoka; FARAJ, Sheila Friedrich; RIOS, Juliana Trazzi; LIMA, Marcelo Simas De; MARTINS, Bruno Costa; GEIGER, Sebastian Naschold; PENNACCHI, Caterina; GUSMAN, Carla; KAWAGUTI, Fabio Shiguehissa; UEMURA, Ricardo Sato; MELO, Evandro Sobroza de; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground and Aims: Surveillance programs of patients with head and neck cancer (HNC) detect synchronous or metachronous esophageal squamous cell carcinoma (ESCC) in up to 15% of patients. Noninvasive, probe-based confocal laser endomicroscopy (pCLE) technique may improve the diagnosis allowing acquisition of high-resolution in vivo images at the cellular and microvascular levels. The aim of this study was to evaluate the accuracy of pCLE for the differential diagnosis of nonneoplastic and neoplastic Lugol-unstained esophageal lesions in patients with HNC. Methods: Twenty-seven patients with HNC who exhibited Lugol-unstained esophageal lesions at surveillance endoscopy were prospectively included for pCLE. Diagnostic pCLE was followed by subsequent biopsies or endoscopic resection of suspected lesions. A senior pathologist was blinded to the pCLE results. Results: Patients mean age was 59 years (SD = 8.8) and 70.4% were men. All patients were smokers, and 22 patients (81.5%) had a history of alcohol consumption. The locations of HNC were oral cavity (n = 13), larynx (n = 10), and pharynx (n = 4). Thirty-seven lesions in 27 patients were studied. The final diagnoses were ESCC in 17 patients and benign lesions in 20 patients. Sensitivity, specificity, and accuracy of pCLE for the histologic diagnosis of ESCC in patients with HNC were 94.1%, 90.0%, and 91.9%, respectively. Conclusions: First, pCLE is highly accurate for real-time histology of Lugol-unstained esophageal lesions in patients with HNC. Second, pCLE may alter the management of patients under surveillance for ESCC, guiding biopsies and endoscopic resection, avoiding further diagnostic workup or therapy of benign lesions.
conferenceObject COMPARISON OF PLASTIC STENTS AND SELF-EXPANDING METAL STENTS IN THE ENDOSCOPIC DRAINAGE OF MALIGNANT HILAR BILIARY OBSTRUCTION(2023) MENDIETA, Pastor Joaquin Ortiz; MARTINS, Bruno; CENTENO, Deborah; GREGORIO, Julia; SUETA, Rafael; SAFATLE-RIBEIRO, Adriana; PENNACCHI, Caterina; GUSMON, Carla; KAWAGUTI, Fabio; PAULO, Gustavo De; LENZ, Luciano; LIMA, Marcelo; UEMURA, Ricardo; NOBRE, Renata; GEIGER, Sebastian; MALUF-FILHO, FauzeconferenceObject COMPARISON OF PLASTIC STENTS AND SELFEXPANDING METAL STENTS IN THE ENDOSCOPIC DRAINAGE OF MALIGNANT HILAR BILIARY OBSTRUCTION(2023) MENDIETA, Pastor Joaquin Ortiz; MARTINS, Bruno; CENTENO, Deborah; GREGORIO, Julia; SUETA, Rafael; SAFATLE-RIBEIRO, Adriana; PENNACCHI, Caterina; GUSMON, Carla; KAWAGUTI, Fabio; PAULO, Gustavo De; LENZ, Luciano; LIMA, Marcelo; UEMURA, Ricardo; NOBRE, Renata; GEIGER, Sebastian; MALUF, Fauze