FABIO GUILHERME CASERTA MARYSSAEL DE CAMPOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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- Doppler-guided hemorrhoidal dearterialization/transanal hemorrhoidal dearterialization: Technical evolution and outcomes after 20 years(2016) FIGUEIREDO, Marleny Novaes; CAMPOS, Fabio GuilhermeIn the setting of Hemorrhoidal Disease treatment, the option of conventional hemorrhoidectomy is highly effective, but it is still associated with postoperative pain and discomfort. For this reason, technical alternatives have been developed in order to reduce complications and to provide better postoperative recovery. To accomplish this aim, non-excisional techniques such as stapled hemorrhoidectomy and Doppler-guided hemorrhoidal ligation have been introduced into clinical practice with high expectations. The aim of this article is to revise the literature about transanal hemorrhoidal dearterialization technique in the treatment of hemorrhoidal disease, looking into its evolution, results and possible benefits over other modalities of surgical treatment. The literature review showed that Doppler-guided hemorrhoidal dearterialization is a safe and effective method to treat grades II to IV hemorrhoidal disease. Outcomes in patients presenting prolapse are satisfactory and the association of anopexy is an important aspect of this operation. Anal physiology disturbances are rarely observed and mainly transitory. This technique is an excellent option for every patient, especially in those with previous anal surgeries and in patients with previous alterations of fecal continence, when an additional procedure might represent a risk of definitive incontinence.
- Current trends regarding protective ileostomy after restorative proctocolectomy(2013) CAMPOS, Fabio Guilherme C. M. deThe decision to perform a protective ileostomy after ileoanal-pouch anastomosis is controversial, and most of the discussion is based on its advantages and disadvantages. Although a temporary intestinal diversion has been routinely indicated in most patients, this choice is also associated with complications. The present work aims to review the outcomes after restorative proctocolectomy with or without a protective ileostomy in the treatment of ulcerative colitis and polyposis syndromes. Most papers emphasize that diversion protects against anastomosis leaks; consequently, it may prevent pelvic sepsis and pouch failure. Otherwise, a defunctioning ileostomy may cause morbidity such as dehydration, electrolyte imbalance, psychological problems, skin irritation, anastomosis strictures and intestinal obstruction, among others. There are those who believe that the omission of an ileostomy after the confection of ileal pouches should be reserved for selected patients, with quite acceptable results. The selection criteria should include surgeon, patient and procedure features to ensure a good outcome
- Incidence of colorectal cancer in young patients(2017) CAMPOS, FÁBIO GUILHERME C. M. DE; FIGUEIREDO, MARLENY NOVAES; MONTEIRO, MARIANE; NAHAS, SÉRGIO CARLOS; CECCONELLO, IVANABSTRACT Sporadic colorectal cancer (CRC) is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC) when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results.
- Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review(2016) FIGUEIREDO, Marleny Novaes; CAMPOS, Fabio Guilherme; D'ALBUQUERQUE, Luiz Augusto; NAHAS, Sergio Carlos; CECCONELLO, Ivan; PANIS, YvesAIM: To perform a systematic review focusing on short-term outcomes after colorectal surgery in patients with previous abdominal open surgery (PAOS). METHODS: A broad literature search was performed with the terms ""colorectal"", ""colectomy"", ""PAOS"", ""previous surgery"" and ""PAOS"". Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS, whether descriptive or comparative. Endpoints of interest were conversion rates, inadvertent enterotomy and morbidity. Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS: From a total of 394 citations, 13 full-texts achieved selection criteria to be included in the study. Twelve of them compared patients with and without PAOS. All studies were retrospective and comparative and two were case-matched. The selected studies comprised a total of 5005 patients, 1865 with PAOS. Among the later, only 294 (16%) had history of a midline incision for previous gastrointestinal surgery. Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopy was more prevalent in 3 of 5 studies that disclosed this event. Morbidity was similar in the majority of studies. A quantitative analysis (meta-analysis) could not be performed due to heterogeneity of the studies. CONCLUSION: Conversion rates were slightly higher in PAOS groups, although not statistical significant in most studies. History of PAOS did not implicate in higher morbidity rates.
- The life and legacy of William Ernest Miles (1869-1947): a tribute to an admirable surgeon(2013) CAMPOS, Fabio GuilhermeThe present article aimed to review some important aspects regarding the work and life of the legendary English surgeon William Ernest Miles. His masterwork began at the beginning of the 20th century, when he devised the first radical procedure that aimed to control rectal cancer, after analyzing the poor outcomes of perineal resections for the disease. The famous 1908 publication, focusing on the technique and early results of abdominoperineal excision influenced numerous surgeons for decades, at a time when most rectal tumors were managed through rectal amputation, regardless of their location. Miles was recognized as a brilliant, fast, and skilled surgeon, and his fame attracted many surgeons to watch him at work in London at that time. He was also recognized as a gentle and kind man who became a trusted leader in coloproctology. In this context, he also made various contributions in the field of anorectal diseases, such as hemorrhoids, anal fistula, anal fissure, and rectal procidentia. Thus, he deserves the honors as the pioneer in the elaboration and refinement of a surgical technique that allowed a significant decrease in tumor recurrence and mortality. Furthermore, the Miles operation shifted the perspectives of rectal cancer, and for that his name will always be regarded as one of the giants in the history of colorectal surgery.
- Colorectal cancer risk in hamartomatous polyposis syndromes(2015) CAMPOS, Fabio Guilherme; FIGUEIREDO, Marleny Novaes; MARTINEZ, Carlos Augusto RealColorectal cancer (CRC) is a major cause of morbidity and mortality around the world, and approximately 5% of them develop in a context of inherited mutations leading to some form of familial colon cancer syndromes. Recognition and characterization of these patients have contributed to elucidate the genetic basis of CRC. Polyposis Syndromes may be categorized by the predominant histological structure found within the polyps. The aim of the present paper is to review the most important clinical features of the Hamartomatous Polyposis Syndromes, a rare group of genetic disorders formed by the peutz-Jeghers syndrome, juvenil polyposis syndrome and PTEN Hamartoma Tumor Syndrome (Bannayan-Riley-Ruvalacaba and Cowden Syndromes). A literature search was performed in order to retrieve the most recent and important papers (articles, reviews, clinical cases and clinical guidelines) regarding the studied subject. We searched for terms such as ""hamartomatous polyposis syndromes"", ""Peutz-Jeghers syndrome"", ""juvenile polyposis syndrome"", ""juvenile polyp"", and ""PTEN hamartoma tumour syndrome"" (Cowden syndrome, Bananyan-Riley-Ruvalcaba). The present article reports the wide spectrum of disease severity and extraintestinal manifestations, with a special focus on their potential to develop colorectal and other neoplasia. In the literature, the reported colorectal cancer risk for Juvenile Polyposis, Peutz-Jeghers and PTEN Hamartoma Tumor Syndromes are 39%-68%, 39%-57% and 18%, respectively. A review regarding cancer surveillance recommendations is also presented.
- Duodenal adenoma surveillance in patients with familial adenomatous polyposis(2015) CAMPOS, Fabio Guilherme; SULBARAN, Marianny; SAFATLE-RIBEIRO, Adriana Vaz; MARTINEZ, Carlos Augusto RealFamilial adenomatous polyposis (FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patient's age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion (1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP.