GUSTAVO ANDRADE DE PAULO
Índice h a partir de 2011
6
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- 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, Fauze- II Brazilian consensus statement on endoscopic ultrasonography(2017) MALUF-FILHO, Fauze; OLIVEIRA, Joel Fernandez de; MENDONCA, Ernesto Quaresma; CARBONARI, Augusto; MACIENTE, Bruno Antonio; SALOMAO, Bruno Chaves; MEDRADO, Bruno Frederico; DOTTI, Carlos Marcelo; LOPES, Cesar Vivian; BRAGA, Claudia Utsch; DUTRA, Daniel Alencar M.; RETES, Felipe; NAKAO, Frank; SOUSA, Giovana Biasia de; PAULO, Gustavo Andrade de; ARDENGH, Jose Celso; SANTOS, Juliana Bonfim dos; SAMPAIO, Luciana Moura; OKAWA, Luciano; ROSSINI, Lucio; CARDOSO, Manoel Carlos de Brito; CAMUNHA, Marco Antonio Ribeiro; CLARENCIO, Marcos; SANTOS, Marcos Eduardo Lera dos; FRANCO, Matheus; SCHNEIDER, Nutianne Camargo; MASCARENHAS, Ramiro; RODA, Rodrigo; MATUGUMA, Sergio; GUARALDI, Simone; FIGUEIREDO, VivianeBackground and Objectives: At the time of its introduction in the early 80s, endoscopic ultrasonography (EUS) was indicated for diagnostic purposes. Recently, EUS has been employed to assist or to be the main platform of complex therapeutic interventions. Methods: From a series of relevant new topics in the literature and based on the need to complement the I Brazilian consensus on EUS, twenty experienced endosonographers identified and reviewed the pertinent literature in databases. The quality of evidence, strength of recommendations, and level of consensus were graded and voted on. Results: Consensus was reached for eight relevant topics: treatment of gastric varices, staging of nonsmall cell lung cancer, biliary drainage, tissue sampling of subepithelial lesions (SELs), treatment of pancreatic fluid collections, tissue sampling of pancreatic solid lesions, celiac neurolysis, and evaluation of the incidental pancreatic cysts. Conclusions: There is a high level of evidence for staging of nonsmall cell lung cancer; biopsy of SELs as the safest method; unilateral and bilateral injection techniques are equivalent for EUS-guided celiac neurolysis, and in patients with visible ganglia, celiac ganglia neurolysis appears to lead to better results. There is a moderate level of evidence for: yield of tissue sampling of pancreatic solid lesions is not influenced by the needle shape, gauge, or employed aspiration technique; EUS-guided and percutaneous biliary drainage present similar clinical success and adverse event rates; plastic and metallic stents are equivalent in the EUS-guided treatment of pancreatic pseudocyst. There is a low level of evidence in the routine use of EUS-guided treatment of gastric varices.
conferenceObject Underwater Endoscopic Mucosal Resection for Non-Pendulated Colorectal Lesions. Is the Distal Cap Really Necessary?(2017) LENZ, Luciano; OLIVEIRA, Joel; MENDONCA, Ernesto Q.; GONZALEZ, Esteban H.; MINATA, Mauricio K.; PAULO, Gustavo A. de; GEIGER, Sebastian N.; SORBELLO, Mauricio; LIMA, Marcelo A.; KAWAGUTI, Fabio S.; MARTINS, Bruno da Costa; BABA, Elisa R.; SAFATLE-RIBEIRO, Adriana V.; GUSMON, Carla C.; PENNACCHI, Caterina; UEMURA, Ricardo S.; TELLIAN, Alexandre; ROLIM, Fausto; HASHIMOTO, Claudio; RIBEIRO, Ulysses; MALUF-FILHO, FauzeconferenceObject Clinical Outcomes of Endoscopic Submucosal Dissection for Superficial Esophageal Neoplasms of Patients With Head and Neck Cancer(2017) OLIVEIRA, Joel F.; MENDONCA, Ernesto Q.; MARTINS, Bruno da Costa; KAWAGUTI, Fabio S.; LIMA, Marcelo S. de; GEIGER, Sebastian N.; PENNACCHI, Caterina; GUSMON, Carla C.; UEMURA, Ricardo S.; BABA, Elisa R.; SAFATLE-RIBEIRO, Adriana V.; BASTOS, Victor R.; MOURA, Renata N.; LENZ, Luciano; PAULO, Gustavo A. de; MINATA, Mauricio K.; SORBELLO, Mauricio; RIBEIRO, Ulysses; MALUF-FILHO, FauzeconferenceObject Clinical and Endoscopic Features of Metastases to the Gastrointestinal Tract(2017) MINATA, Mauricio K.; LENZ, Luciano; SAFATLE-RIBEIRO, Adriana V.; MARTINS, Bruno; RETES, Felipe A.; KAWAGUTI, Fabio S.; BABA, Elisa R.; LIMA, Marcelo A.; GEIGER, Sebastian N.; PENNACCHI, Caterina; MATUGUMA, Sergio E.; PAULO, Gustavo A. de; UEMURA, Ricardo S.; GUSMON, Carla C.; SORBELLO, Mauricio; OLIVEIRA, Joel F.; MENDONCA, Ernesto Q.; RIBEIRO, Ulysses; MALUF-FILHO, Fauze- Guidelines for the management of neuroendocrine tumours by the Brazilian gastrointestinal tumour group(2017) RIECHELMANN, Rachel P.; WESCHENFELDER, Rui F.; COSTA, Frederico P.; ANDRADE, Aline Chaves; OSVALDT, Alessandro Bersch; QUIDUTE, Ana Rosa P.; SANTOS, Allan dos; HOFF, Ana Amelia O.; GUMZ, Brenda; BUCHPIGUEL, Carlos; PEREIRA, Bruno S. Vilhena; LOURENCO JUNIOR, Delmar Muniz; ROCHA FILHO, Duilio Reis da; FONSECA, Eduardo Antunes; MELLO, Eduardo Linhares Riello; MAKDISSI, Fabio Ferrari; WAECHTER, Fabio Luiz; CARNEVALE, Francisco Cesar; COURA-FILHO, George B.; PAULO, Gustavo Andrade de; GIROTTO, Gustavo Colagiovanni; BEZERRA NETO, Joao Evangelista; GLASBERG, Joao; CASALI-DA-ROCHA, Jose Claudio; REGO, Juliana Florinda M.; MEIRELLES, Luciana Rodrigues de; HAJJAR, Ludhmila; MENEZES, Marcos; BRONSTEIN, Marcello D.; SAPIENZA, Marcelo Tatit; FRAGOSO, Maria Candida Barisson Villares; PEREIRA, Maria Adelaide Albergaria; BARROS, Milton; FORONES, Nora Manoukian; AMARAL, Paulo Cezar Galvao do; MEDEIROS, Raphael Salles Scortegagna de; ARAUJO, Raphael L. C.; BEZERRA, Regis Otaviano Franca; PEIXOTO, Renata D'Alpino; AGUIAR JR., Samuel; RIBEIRO JR., Ulysses; PFIFFER, Tulio; HOFF, Paulo M.; COUTINHO, Anelisa K.Neuroendocrine tumours are a heterogeneous group of diseases with a significant variety of diagnostic tests and treatment modalities. Guidelines were developed by North American and European groups to recommend their best management. However, local particularities and relativisms found worldwide led us to create Brazilian guidelines. Our consensus considered the best feasible strategies in an environment involving more limited resources. We believe that our recommendations may be extended to other countries with similar economic standards.
- Adverse events of self-expandable esophageal metallic stents in patients with long-term survival from advanced malignant disease(2017) MEDEIROS, Vitor Sousa; MARTINS, Bruno Costa; LENZ, Luciano; RIBEIRO, Maria Sylvia Ierardi; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas; SAFATLE-RIBEIRO, Adriana Vaz; KAWAGUTI, Fabio Shiguehissa; PENNACCHI, Caterina; GEIGER, Sebastian N.; BASTOS, Victor R.; RIBEIRO-JUNIOR, Ulysses; SALLUM, Rubens A.; MALUF-FILHO, FauzeBackground and Aims: Self-expandable metallic stents are considered the best palliative treatment of dysphagia for patients with advanced esophageal cancer. Adverse events (AEs) are a major concern, especially in patients with better prognosis and longer survival. The present study aimed to evaluate the AEs of patients who survived longer than 6 months with esophageal stents in place. Methods: This is a retrospective analysis of a prospectively collected database including all patients submitted to esophageal stent placement for the palliation of malignant diseases during the period from February 2009 to February 2014 at a tertiary care academic center who had stents longer than 6 months. Results: Sixty-three patients were included. Mean follow-up was 10.7 months. Clinical success was achieved in all patients, and the median stent patency was 7.1 months. AEs occurred in 40 patients (63.5%), totaling 62 AEs (mean, 1.5 AEs per patient). Endoscopic management of AEs was successful in 84.5% of cases, with a mean of 1.6 reinterventions per patient. The univariate analysis revealed that performance status, age, and post-stent radiotherapy presented a trend to higher risk of AEs. The multivariate analysis revealed that only performance status was associated with AEs (P = .025; hazard ratio, 4.1). Conclusions: AEs are common in patients with long-term esophageal stenting for malignancy. However, AEs were not related to higher mortality rate, and most AEs could be successfully managed by endoscopy. Only performance status was a risk factor for AEs. Our data suggest that metallic stenting is a valid option for the treatment of malignant esophageal conditions, even when survival longer than 6 months is expected.