EDUARDO MONTAG
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Liposuction Induces a Compensatory Increase of Visceral Fat Which Is Effectively Counteracted by Physical Activity: A Randomized Trial(2012) BENATTI, Fabiana; SOLIS, Marina; ARTIOLI, Guilherme; MONTAG, Eduardo; PAINELLI, Vitor; SAITO, Fabio; BAPTISTA, Luciana; COSTA, Luiz Augusto; NEVES, Rodrigo; SEELAENDER, Marilia; FERRIOLLI, Eduardo; PFRIMER, Karina; LIMA, Fernanda; ROSCHEL, Hamilton; GUALANO, Bruno; LANCHA JR., AntonioContext: Liposuction is suggested to result in long-term body fat regain that could lead to increased cardiometabolic risk. We hypothesized that physical activity could prevent this effect. Objective: Our objective was to investigate the effects of liposuction on body fat distribution and cardiometabolic risk factors in women who were either exercise trained or not after surgery. Design, Setting, and Participants: Thirty-six healthy normal-weight women participated in this 6-month randomized controlled trial at the University of Sao Paulo, Sao Paulo, Brazil. Interventions: Patients underwent a small-volume abdominal liposuction. Two months after surgery, the subjects were randomly allocated into two groups: trained (TR, n = 18, 4-month exercise program) and nontrained (NT, n = 18). Main Outcome Measures: Body fat distribution (assessed by computed tomography) was assessed before the intervention (PRE) and 2 months (POST2), and 6 months (POST6) after surgery. Secondary outcome measures included body composition, metabolic parameters and dietary intake, assessed at PRE, POST2, and POST6, and total energy expenditure, physical capacity, and sc adipocyte size and lipid metabolism-related gene expression, assessed at PRE and POST6. Results: Liposuction was effective in reducing sc abdominal fat (PRE vs. POST2, P = 0.0001). Despite the sustained sc abdominal fat decrement at POST6 (P = 0.0001), the NT group showed a significant 10% increase in visceral fat from PRE to POST6 (P = 0.04; effect size = -0.72) and decreased energy expenditure (P = 0.01; effect size = 0.95) when compared with TR. Dietary intake, adipocyte size, and gene expression were unchanged over time. Conclusion: Abdominal liposuction does not induce regrowth of fat, but it does trigger a compensatory increase of visceral fat, which is effectively counteracted by physical activity.
- The Liposuction-Induced Effects on Adiponectin and Selected Cytokines Are Not Affected by Exercise Training in Women(2014) SOLIS, Marina Yazigi; ARTIOLI, Guilherme Giannini; MONTAG, Eduardo; PAINELLI, Vitor de Salles; SAITO, Fabio Lopes; LIMA, Fernanda Rodrigues; ROSCHEL, Hamilton; GUALANO, Bruno; LANCHA JUNIOR, Antonio Herbert; BENATTI, Fabiana BragaIt has been suggested that the abrupt liposuction-induced decrease in adipose tissue could affect adipokine secretion pattern. We hypothesized that exercise training could positively impact adipokine metabolism following liposuction. The aim of this study was to investigate the effects of liposuction on inflammation-related adipokines in women who were either exercise-trained or remained sedentary after surgery. Thirty-six healthy normal-weight women underwent an abdominal liposuction and two months after surgery were randomly allocated into two groups: trained (TR, n = 18, four-month exercise program) and nontrained (NT, n = 18). Inflammation-related adipokine serum levels (TNF-alpha, IL-6, IL-10, and adiponectin) and abdominal and thigh subcutaneous adipose tissue (scAT) mRNA levels were assessed before (PRE) and six months after surgery (POST6). TNF-alpha, IL-6, and IL-10 serum levels were unchanged in both groups. In contrast, TNF-alpha, IL-6, and IL-10 mRNA levels in scAT were increased, whereas adiponectin scAT mRNA and serum levels were decreased at POST6 (P < 0.05, main effect for time). No changes were observed in mRNA levels of MCP-1, CD14, and CD68 in any of the groups. In conclusion, liposuction downregulates adiponectin scAT gene expression and serum levels and upregulates scAT gene expression of inflammation-related genes six months after surgery in normal-weight women, irrespective of exercise training.
- Avaliação do índice de infecção de implantes mamários utilizados na reconstrução de mama do Instituto do Câncer do Estado de São Paulo(2014) ALMEIDA, PATRÍCIA NORONHA DE; ARRUDA, EDUARDO GUSTAVO PIRES DE; OKADA, ALBERTO; MONTAG, EDUARDO; FERREIRA, MARCUS CASTRO; BUSNARDO, FÁBIO FREITAS; FONSECA, ALEXANDRE SIQUEIRAABSTRACT Introduction: Placement of breast implants is the most commonly used form of breast reconstruction. Despite its advantages, infection of the implant, either in the tissue expander or mammary prosthesis, can be a significant problem, including the need to remove it. The objective of this work is to evaluate the infection rate of breast implants used for breast reconstruction in patients submitted to surgery at the Cancer Institute of the State of São Paulo (ICESP), as well as its correlation with clinical, oncological, and surgical factors. Patients and methods: This is a retrospective study on 120 patients submitted to breast reconstruction with breast implants at the ICESP from February 2009 to March 2010. Results: The infection rate (24.3%) was statistically related to immediate reconstruction (88.9%), diabetes mellitus (25%), body mass index >30 (52.8%), systemic arterial hypertension (52.8%), and skin injury due to mastectomy (27.8%). Of the infected implants, 44% were removed, most of which were expanders placed during immediate reconstruction. Conclusions: Breast reconstruction with implants is the safest and most effective form of treatment. However, consideration should be given to patients who are prone to the development of infection, in order to optimize its prevention and attempt to perform its treatment at an early stage.
- Serratus anterior muscle flap as a salvage procedure in exposed implant-based breast reconstruction(2019) MONTAG, Eduardo; OKADA, Alberto; ARRUDA, Eduardo G. P.; MUNHOZ, Alexandre M.; BUSNARDO, Fabio F.; GEMPERLI, RolfBACKGROUND: Implant-based breast reconstruction (IBR) is the most common approach to reconstruct mastectomy deffects. Infection following breast reconstruction can be devastating and lead to loss of the reconstruction due to the need of implant removal. The serratus anterior muscle flap is widely used during breast reconstruction to provide coverage of the implant/expander. METHODS: We present the application of the serratus anterior muscle flap to treat implant exposure after breast reconstruction. CASES PRESENTATION: Two patients who experienced implant exposure after breast reconstruction were successfully treated with partial capsulectomy, pocket irrigation and implant coverage with a serratus anterior muscle flap. RESULTS: No post operative complications have been observed while implant retention was achieved in both cases. CONCLUSIONS: The serratus anterior muscle flap is an option to treat implant exposure following breast reconstruction in selected cases. This flap could be used to prevent implant exposure in critical cases. (C) 2019 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
- Influência do posicionamento do retalho linfonodal vascularizado na resposta ao tratamento cirúrgico do linfedema secundário ao câncer de mama.(2019) MONTAG, Eduardo; OKADA, Alberto Yoshikazu; ARRUDA, Eduardo Gustavo Pires; FONSECA, Alexandre Siqueira; BROMLEY, Miluska; MUNHOZ, Alexandre Mendonça; BUSNARDO, Fábio Freitas; GEMPERLI, RolfABSTRACT Objective: to evaluate the initial therapeutic experience of transplantation of vascularized lymph nodes in patients with lymphedema of the upper limbs secondary to the treatment of breast cancer, and to verify if the positioning of the transplant influences the surgical result. Methods: we conducted a prospective, comparative test of two therapeutic modalities, with 24 patients with lymphedema of the upper limb after breast cancer treatment, classified as grades 2 and 3, according to the International Lymphedema Society. The two types of procedures performed were: 1) total breast reconstruction with - deep inferior epigastric perforator (DIEP) flap associated with lymph node flap, in patients with no previous breast reconstruction or loss of previous reconstruction (axillary positioning); 2) isolated inguinal lymph node flap performed in patients with completed breast reconstruction or without the desire to perform the breast reconstruction (wrist positioning). Results: the reduction percentage of the affected limb volume was 20.1% (p=0.0370). The number of infectious episodes (cellulites) also decreased significantly, from 41% in the preoperative period to 12.5% in the postoperative one (p=0.004). There were no differences between the proximal and distal groups. Conclusion: the transplantation of lymph nodes positively affected the postoperative evolution of patients with lymphedema secondary to breast cancer. We observed no differences in relation to flap positioning.
- Influence of advanced age on postoperative outcomes and total loss following breast reconstruction: a critical assessment of 560 cases(2018) MATSUMOTO, WALTER KOITI; MUNHOZ, ALEXANDRE MENDONÇA; OKADA, ALBERTO; MONTAG, EDUARDO; ARRUDA, EDUARDO GUSTAVO; FONSECA, ALEXANDRE; FERRARI, ORLANDO; BRASIL, JOSÉ AUGUSTO; PRETTI, LIA; FILASSI, JOSÉ ROBERTO; GEMPERLI, ROLFABSTRACT Objective: to evaluate the role of age in the risk of postoperative complications in patients submitted to unilateral breast reconstruction after mastectomy, with emphasis on total reconstruction loss. Methods: we conducted a retrospective study of patients submitted to breast reconstruction, whose variables included: oncological and reconstruction data, postoperative complications, including loss of reconstruction and complications of surgical wound. We divided the patients into two groups, according to the classification of the Brazilian National Elderly Policy and the Statute of the Elderly: young (age <60 years) and elderly (60 years or more). We also grouped them according to the World Health Organization classification: young people (age <44 years), middle age (45-59 years); elderly (age 60-89 years) and extreme advanced age (90 years or older). We applied the surgical risk classification of the American Society of Anesthesiologists to investigate the role of the preoperative physical state as a possible predictor of complications. Results: of the 560 patients operated on, 94 (16.8%) were 60 years of age or older. We observed a local complication rate of 49.8%, the majority being self-limited. The incidences of necrosis, infection and dehiscence were 15.5%, 10.9% and 9.3%, respectively. Patients older than 60 years presented a chance of complication 1.606 times greater than the younger ones. Forty-five (8%) patients had loss of the reconstruction; there was no statistically significant difference in the mean age of the patients who presented this result or not (p=0.321). Conclusion: in selected patients, breast reconstruction can be considered safe; most documented complications were limited and could be treated conservatively.