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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Resultados de Busca
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- 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 vacuum therapy in a patient without nasal access(2023) LIMA, Marcelo Simas de; CENTENO, Deborah Marques; SUETA, Rafael Utimura; MENDIETA, Pastor Joaquin Ortiz; GREGORIO, Julia Mayumi; UEMURA, Ricardo Sato; MALUF-FILHO, Fauze
- Endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of early rectal cancer(2014) KAWAGUTI, Fabio Shiguehissa; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; MARTINS, Bruno da Costa; RETES, Felipe Alves; MEDEIROS, Raphael Salles S.; HAYASHI, Takemasa; WADA, Yoshiki; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; NAHAS, Sergio Carlos; KUDO, Shin-ei; MALUF, FauzeEndoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) are minimally invasive procedures that can be used to treat early rectal cancer. The aim of this study was to compare clinical efficacy between ESD and TEM for the treatment of early rectal cancer. Between July 2008 and August 2011, 24 patients with early rectal cancers were treated by ESD (11) or TEM (13) at the Cancer Institute of So Paulo University Medical School (So Paulo, Brazil). Data were analyzed retrospectively according to database and pathological reports, with respect to en bloc resection rate, local recurrence, complications, histological diagnosis, procedure time and length of hospital stay. En bloc resection rates with free margins were achieved in 81.8 % of patients in the ESD group and 84.6 % of patients in the TEM group (p = 0.40). Mean tumor size was 64.6 +/- A 57.9 mm in the ESD group and 43.9 +/- A 30.7 mm in the TEM group (p = 0.13). Two patients in the TEM group and one patient in the ESD group had a local recurrence. The mean procedure time was 133 +/- A 94.8 min in the ESD group and 150 +/- A 66.3 min in the TEM group (p = 0.69). Mean hospital stay was 3.8 +/- A 3.3 days in the ESD group and 4.08 +/- A 1.7 days in the TEM group (p = 0.81). This was a non-randomized clinical trial with a small sample size and selection bias in treatment options. ESD and TEM are both safe and effective for the treatment of early rectal cancer.