FABIO GUILHERME CASERTA MARYSSAEL DE CAMPOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
14 resultados
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- Surgical Technique and Considerations about Transanal Transection and Single-Stapled (TTSS) Anastomosis: The Search for a Perfect Anastomosis(2021) CAMPOS, Fábio Guilherme; PANDINI, Rafael Vaz; BUSTAMANTE-LOPEZ, Leonardo Alfonso; NAHAS, Sérgio CarlosAbstract The evaluation of preventivemeasures and risk factors for anastomotic leakage has been a constant concern among colorectal surgeons. In this context, the description of a new way to perform a colorectal, coloanal or ileoanal anastomosis, known as transanal transection and single-stapled (TTSS) anastomosis, deserves an appreciation of its qualities, and a discussion about its properties and technical details. In the present paper, the authors review themost recent efforts aiming to reduce anastomotic dehiscence, and describe the TTSS technique in a patient submitted to laparoscopic total proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis. Surgical perception raises important advantages such as distal rectal transection under visualization, elimination of double-stapling lines (with cost-effectiveness and potential protection against suture dehiscence), elimination of dog ears, and the opportunity to be accomplished via a transanal approach after open, laparoscopic, or robotic colorectal resections. Future studies to confirm these supposed advantages are needed.
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.- PROGNOSTIC FACTORS FOR LEFT COLECTOMY FOR COLON CANCER: A TEN YEARS EXPERIENCE OF A SINGLE UNIVERSITY INSTITUTION(2017) NAHAS, Sergio Carlos; NAHAS, Caio Sergio; BUSTAMANTE-LOPEZ, Leonardo Alfonso; PINTO, Rodrigo Ambar; MARQUES, Carlos Frederico Sparapan; CAMPOS, Fabio Guilherme; CECCONELLO, IvanABSTRACT Background: Colorectal cancer is the third most common cancer in the world. In Brazil, it is the leading cause of cancer in the gastrointestinal tract. Aim: To evaluate the preoperative, perioperative, and postoperative risk factors for recurrence and overall survival of patients with left colon cancer operated during a ten-year period. Methods: Patients with left colon cancer surgically treated underwent clinical preoperative workout and cancer staging. The following factors were studied: gender, age, tumor location, T stage, lymph node yield, N stage, M stage, histological type, and tumor differentiation. It was analyzed the influence in five-year overall survival. Results: A total of 173 patients underwent left colectomy for colon cancer. There was a slight predominance of male gender with 50.9%. The mean age was 60.8 years old. Fifteen (8.7%) tumors were located at splenic flexure, 126 (72.8%) at sigmoid colon, and 32 (18.5%) at descending colon. The median length of hospital stay was seven days. Mean survival was 47.5 months. At 60 months seven patients (4%) lost follow-up, 38 patients (21.9%) deceased and 135 patients (78%) were alive. Overall survival time was 48 months. Conclusion: Advanced stages (T3-T4, N+ and M+) were the only factors associated with poor long term survival in left colon cancer.
conferenceObject KI-67 EXPRESSION CAN BE A MARKER OF AGRESSIVENESS OF DUODENAL DISEASE IN FAMILIAL ADENOMATOUS POLYPOSIS(2020) SULBARAN, Marianny; CAMPOS, Fabio G.; PAES, Vitor R.; ALVES, Venancio A.; KISHI, Humberto; MOURA, Eduardo G. de; BUSTAMANTE-LOPEZ, Leonardo A.; NAHAS, Sergio C.; RIBEIRO, Ulysses; COUDRY, Renata; SAFATLE, Adriana V.- Adoption rates of laparoscopic techniques for colorectal resections among Brazilian surgeons: limiting factors affecting incorporation into daily practice(2019) CAMPOS, Fábio Guilherme; BERTONCINI, Alexandre Bruno; MARTINEZ, Carlos Augusto Real; BUSTAMANTE-LOPEZ, Leonardo Alphonso; MORAIS, Paula Gabriela MeloABSTRACT Routine adoption of laparoscopy in clinical practice and Medical Residency has not been widely evaluated in Brazil so far. Aim: To take an overview on the adoption and limitations concerning the use of laparoscopic techniques among Brazilian colorectal surgeons. Methods: A questionnaire was sent to 1870 SBCP filiated members, containing personal and professional data such as sex, age, length and local of practice, SBCP filliation, number of procedures, treatment of cancer and laparoscopy limitations. Results: 418 members (22.4%) sent their response (80% men and 20% women). 110 members (26.3%) affirmed they don't perform any laparoscopic procedure, while 308 (73.7%) have already adopted laparoscopy as a routine. An average number of 7.6 laparoscopic colorectal procedures were declared to be performed per month (1 to 40 procedures). Laparoscopic adoption rates were favourably influenced by young age members (46% vs. 28%) and affiliation to University hospitals (p = 0.01). Conversely, surgeons from private clinic showed a greater tendency of no adoption. Among the 308 responders, 106 (34.4%) have already surpassed more than 100 laparoscopic cases, and 167 (54.2%) reported an experience of more than 50 operated patients. The group of surgeons not using minimally invasive techniques incriminated lack of training (73.6%) and laparoscopic instruments availability (27.3%) as the main reasons for no adoption. Conclusions: Adoption rate of laparoscopic techniques to treat colorectal diseases is still low (at least 17%). Future efforts should focus on providing supervised training, proctorship during the initial experience and help instrumental acquisition in centers willing to change their routine and perspectives.
- LAPAROSCOPIC SPLENIC FLEXURE MOBILIZATION: TECHNICAL ASPECTS, INDICATION CRITERIA AND OUTCOMES(2021) CAMPOS, Fabio Guilherme; BUSTAMANTE-LOPEZ, Leonardo Alfonso; MARTINEZ, Carlos Augusto
- Risk factors for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis: a prospective, single-center study(2018) SULBARAN, M.; CAMPOS, F. G.; RIBEIRO JR., U.; KISHI, H. S.; SAKAI, P.; MOURA, E. G. H. de; BUSTAMANTE-LOPEZ, L.; TOMITAO, M.; NAHAS, S. C.; CECCONELLO, I.; SAFATLE-RIBEIRO, A. V.Background and study aims To determine the clinical features associated with advanced duodenal and ampullary adenomas in familial adenomatous polyposis. Secondarily, we describe the prevalence and clinical significance of jejunal polyposis. Patients and methods This is a single center, prospective study of 62 patients with familial adenomatous polyposis. Duodenal polyposis was classified according to Spigelman and ampullary adenomas were identified. Patients with Spigelman III and IV duodenal polyposis underwent balloon assisted enteroscopy. Predefined groups according to Spigelman and presence or not of ampullary adenomas were related to the clinical variables: gender, age, family history of familial adenomatous polyposis, type of colorectal surgery, and type of colorectal polyposis. Results Advanced duodenal polyposis was present in 13 patients (21%; 9 male) at a mean age of 37.61 +/- 13.9 years. There was a statistically significant association between family history of the disease and groups according to Spigelman (P=0.03). Seven unrelated patients (6 male) presented ampullary adenomas at a mean age of 36.14 +/- 14.2 years. The association between ampullary adenomas and extraintestinal manifestations was statistically significant in multivariate analysis (P=0.009). Five endoscopic types of non-ampullary adenoma were identified, showing that lesions larger than 10mm or with a central depression presented foci of high grade dysplasia. Among 28 patients in 12 different families, a similar Spigelman score was identified; 10/12 patients (83.3%) who underwent enteroscopy presented small tubular adenomas with low grade dysplasia in the proximal jejunum. Conclusions Advanced duodenal polyposis phenotype may be predictable from disease severity in a first-degree relative. Ampullary adenomas were independently associated with the presence of extraintestinal manifestations.
- Upper gastrointestinal neoplasia in familial adenomatous polyposis: prevalence, endoscopic features and management(2019) CAMPOS, Fabio Guilherme; MARTINEZ, Augusto Real; SULBARAN, Marianny; BUSTAMANTE-LOPEZ, Leonardo Alfonso; SAFADE-RIBEIRO, Adriana VazBackground: To evaluate the prevalence of upper gastrointestinal (GI) polyps in familial adenomatous polyposis (FAP), and to discuss current therapeutic recommendations. Methods: Clinical, endoscopic, histological and treatment data were retrieved from charts of 102 patients [1958-2016]. Duodenal adenomatosis was classified according to Spigelman stages. Results: this series comprised 59 women (57.8%) and 43 men (42.1%) with a median age of 32.3 years. Patients underwent 184 endoscopic procedures, the first at a median age of 35.9 years (range, 13-75 years). Fundic gastric polyps (n=31; 30.4%) prevailed in the stomach. While only 5 adenomas were found in the stomach, 33 patients (32.4%) presented duodenal ones. Advanced lesions (n=13; 12.7%) were detected in the stomach (n=2) and duodenum (n=11). During follow-up, Spigelman stages improved in 6 (12.2%) patients, remained unchanged in 25 (51.0%) and worsened in 18 (36.7%). Carcinomas were diagnosed in the stomach and duodenum (4 lesions each, 3.9%), at median ages of 50.2 and 55.0 years, respectively. Advanced lesions and carcinomas were managed through local or surgical resections. Severe complications occurred in only 2 patients (one death). Enteroscopy in 21 patients revealed jejunal adenomas in 12, 11 of whom also presented duodenal adenomas. Conclusions: There is a high prevalence of upper GI adenomas and cancer in FAP. There were diagnosed fundic gastric polyps (30.4%), duodenal (32.4%) and jejunal adenomas (11.8%), respectively. One third of duodenal polyps progressed slowly throughout the study. The rates of advanced gastroduodenal lesions (12.7%) and cancer (7.8%) raise the need for continuous surveillance during follow-up.
- Prognostic factors of surgically-treated patients with cancer of the right colon: a ten years' experience of a single universitary institution(2015) NAHAS, Sergio Carlos; NAHAS, Caio Sergio Rizkallah; BUSTAMANTE-LOPEZ, Leonardo Alfonso; PINTO, Rodrigo Ambar; MARQUES, Carlos Frederico Sparapan; CAMPOS, Fabio Guilherme; CECONELLO, IvanBACKGROUND: Colorectal cancer is one of the most common malignancies in the world. There are many controversies in the literature about the prognostic value of primary tumor location. Many studies have shown higher survival rates for tumors in the right colon, and worse prognosis for lesions located more distally in the colon. AIM: To analyze the results of surgical treatment of right-sided colon cancers patients operated in one decade period and identify the prognostic factors that were associated with lower overall survival in stages I-IV patients. METHODS: A retrospective review from the prospectively collected database identified 178 patients with right-sided colon cancer surgically treated with curative intent. Demographic factors (gender and age), tumor factors (site, T stage, N stage, M stage, histological type and tumor differentiation), and lymph node yield were extracted to identify those associated with lower overall survival. RESULTS: Mean age was 65 (±12) years old, and 105 (56.1%) patients were female. Most common affected site was ascending colon (48.1%), followed by cecum (41.7%) and hepatic flexure (10.2%). Mean length of hospital stay was 14 (±2.8) days. T stage distribution was T1 (4.8%), T2 (7.5%), T3 (74.9%), and T4 (12.8%). Nodal involvement was present in 46.0%, and metastatic disease in 3.7%. Twelve or more lymph nodes were obtained in 87.2% of surgical specimens and 84.5% were non-mucinous tumors. Mean survival time was 38.3 (±30.8) months. Overall survival was affected by T stage, N stage, M stage, and final stage. Lymph node involvement (OR=2.06) and stage III/IV (OR=2.81) were independent negative prognostic factors. CONCLUSION: Right-sided colon cancer presented commonly at advanced stage. Advanced stage and lymph node involvement were factors associated with poor long term survival.
- IS IT POSSIBLE TO OPTIMIZE STAPLED HEMORRHOIDOPEXY OUTCOMES BY ENLARGING OPERATIVE CRITERIA INDICATIONS? RESULTS OF A TAILORED PROCEDURE WITH ASSOCIATED RESECTION IN A COMPARATIVE PERSONAL SERIES(2022) CAMPOS, Fabio Guilhermel; CAVALARI-MANCUZO, Daiane; BUSTAMANTE-LOPEZ, Leonardo Alfonso; MORAIS, Paula Gabriela Melo; MARTINEZ, Carlos Augusto RealBACKGROUND: Since its introduction, stapled hemorrhoidopexy has been increasingly esplenectomia (DAPE) associada a terapia endoscopica. Porem, estudos mostram aumento do indicatedcalibre in dasthe varizes managentem algunsof hemorrhoidalpacientes durantdisease. oAIM:Ourseguimento primary em endlong point prazo.was to Objetivo: evaluate Avalar o impacto da DAPE e tratameto endoscopo pos-operatorio no comportmento the incidence of recurrent disease requiring another surgical intervention. On a secondary analysis, we das varizes esofagicas e recidiva hemorragica, de pacientes esquistossomoticos. Metodos: also compared pain, complications, and patient's satisfaction after a tailored surgery. METHODS: We retrospectively reviewed 196 patients (103 males and 93 females) wth a median age of 47.9 years Foram estudados 36 pacientes com seguimento superior a cinco anos, distribuidos em (range, 17-78) who were undergoing stapled hemorrhoidopexy alone (STG; n=65) or combined dois grupos: queda da ressao portal abaixo de 30% e acima de 30% comparados com o surgery (CSG; n=131, stapled hemorrhoidopexy associated with resection). RESULTS: Complications werecalibre dasdetected varizes in 11 (5.6%)esofagicas nopatients (4.6%pos-operatorio for STG vs. precoce6.1% e for tardioCSG; alem p=0.95).do Atindice the de same recidvatime, heorragica. Resultados symptoms recurrence (13.8% vs. 8.4%; p=034), reoperation rate for complications (3.1% vs. 3.0%; esofagicas que, durante o seguimento aumentaram de calibre e foram controladas com p=1.0), and reoperation rate for recurrence (6.1% vs. 4.6%; p=1.0) were not different among groups. Grade IV patients were more commonly managed with simultaneous stapling and resection (63% vs. 49.5%), but none of them presented symptoms recurrence nor need reoperation due to o comportamento do calibre das varizes no pos-operatorio precoce nem tardio nem os recurrence. Median pain score during the first week was higher in CSG patients (0.8 vs. 1.7). After a indicesfollow-up de of recidiva24.9 months, hemorragca. satisfactin Conclusao scores were similar (8.6; p=0.8). CONCLUSION: Recurrent symptoms were observed in 10% of patients, requiring surgery in approximately half of them. Even operatorios precoces ou tardios. A comparacao entre a queda de pressao do portal e as though the association of techniques may raise pain scores, a tailored approach based on amplified indication criteria and combined techniques seems to be an effective and safe alternative, with decreased relapse rates in patients suffering from more advanced hemorrhoidal disease. Satisfaction DESCRITORES: Esquistossomose mansoni. Hipertensao portal. Cirurgia. Pressao na veia porta. Varizes esofagicas scores after hemorrhoidopexy are high.