FABIO GUILHERME CASERTA MARYSSAEL DE CAMPOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Laparoscopic Total Mesorectal Excision for Rectal Cancer after Neoadjuvant Treatment: Targeting Sphincter-Preserving Surgery(2011) ARAUJO, Sergio Eduardo Alonso; SEID, Victor Edmond; BERTONCINI, Alexandre; CAMPOS, Fabio Guilherme; SOUSA JUNIOR, Afonso; NAHAS, Sergio Carlos; CECCONELLO, IvanBackground/Aims: Laparoscopic total mesorectal excision for rectal cancer is under scrutiny. This study aimed at analyzing feasibility, adequacy of resection, impact on early outcomes after neoadjuvant chemoradiation therapy, and to investigate trend towards indication of laparoscopy for sphincter-preservation in a single university medical center. Methodology: Patients with distal rectal cancer submitted to neoadjuvant treatment followed by laparoscopic total mesorectal excision were prospectively enrolled. The studied parameters were: demographics, previous surgery, BMI, type of operation, rate of sphincter-preserving surgery, duration of surgery, conversion, specimen retrieval, lymphadenectomy, distal and radial margins, intra and postoperative morbidity, reoperations, hospital stay, and mortality. Results: From January 2000 to July 2010, 68 patients were enrolled. Mean age was 60 (30-87) years. There were 27 anterior and 41 abdominoperineal resections. Six patients underwent a totally laparoscopic resection and coloanal anastomosis. There was a trend (p=0.003) towards more sphincter-preserving surgery. Conversion was 4.5%. Intraoperative complication was 7.4%. Postoperative complications occurred in 15%. Mortality was 3%. Lymph-node harvest was 11 (0-33). Mean distal margin was 2.5cm (1-4). Radial margins were positive in 3 (10%) cases. Conclusions: Laparoscopic total mesorectal excision after neoadjuvant treatment is feasible and safe. Sphincter-preserving laparoscopic oncologic rectal surgery has been accomplished more frequently.
- Surgical Outcomes of Laparoscopic Colorectal Resections for Familial Adenomatous Polyposis(2011) CAMPOS, Fabio Guilherme; ARAUJO, Sergio Eduardo; MELANI, Armando Geraldo; PANDINI, Luis Claudio; NAHAS, Sergio Carlos; CECCONELLO, IvanBackground: Acceptance of extended laparoscopic colon resections is still controversial besides the growing experience over the years. Aim: The aim of this study was to evaluate the postoperative outcomes of laparoscopic colorectal resections exclusively for familial adenomatous polyposis patients. Methods: Patient data, surgical procedures and operative outcomes from 49 patients submitted to total proctocolectomy (TPC) or total abdominal colectomy (TAC) from 1997 to 2009 were prospectively analyzed. Results: There were 18 (36.7%) men and 31 (63.3%) women, with a median age of 31.1 years. Surgical procedures consisted of 3 TPC with ileostomy (6.1%), 30 restorative TPC with ileoanal anastomosis (61.2%), and 16 TAC with ileorectal anastomosis (32.6%). Only 1 patient (2.0%) required open conversion. No patient required blood transfusion. Median operating time was 289, ranging from 150 to 400 minutes. Twelve patients (24.5%) presented complications and only 1 (2.0%) died. Overall complication rates were similar after TAC or TPC (31.2% vs. 21.2%; P = 0.4). Reoperations were necessary in 7 cases (14.3%), and the median length of hospital stay was 6.2 days (3 to 16). The comparison of 2 consecutive groups of patients over time revealed a little improvement in surgery duration (301 to 276 min; P = 0.16), but relevant reduction in morbidity (32% vs. 16.6%; P = 0.2) and reoperation rates (20% vs. 8.3%; P = 0.4), besides the absence of statistical difference. Conclusions: Laparoscopic TPC and TAC represent an interesting alternative approach for young and motivated familial adenomatous polyposis patients. When performed by experienced surgeons, they provide excellent short-term outcome regarding immediate recovery, morbidity, and cosmesis.