PAULO HERMAN
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
conferenceObject Results of Endoscopic Cyanoacrylate Injection for the Treatment of Esophageal Variceal Hemorrhage in Child-Pugh C Patients(2012) RIBEIRO, Joao Paulo A.; MALUF-FILHO, Fauze; MATUGUMA, Swrgio E.; HERMAN, Paulo; SAKAI, Paulo; D'ALBUQUERQUE, Luiz Augusto C.- Hepatocellular adenoma: an excellent indication for laparoscopic liver resection(2012) HERMAN, Paulo; COELHO, Fabricio Ferreira; PERINI, Marcos Vinicius; LUPINACCI, Renato Micelli; D'ALBUQUERQUE, Luiz Augusto Carneiro; CECCONELLO, IvanObjectives: Laparoscopic resection for benign liver disease has gained wide acceptance in recent years and hepatocellular adenoma (HA) seems to be an appropriate indication. This study aimed to discuss diagnosis and treatment strategies, and to assess the feasibility, safety and outcomes of pure laparoscopic liver resection (LLR) in a large series of patients with HA. Methods: Of 88 patients who underwent pure LLR, 31 were identified as having HA. Diagnosis was based on radiological evaluation and resections were performed for lesions measuring >5.0 cm. Results: The sample included 29 female and two male patients. Their mean age was 33.2 years. A total of 27 patients had a single lesion, one patient had two and one had four lesions. The two remaining patients had liver adenomatosis. Mean tumour size was 7.5 cm. Three right hepatectomies, 17 left lateral sectionectomies and 11 wedge resections or segmentectomies were performed. There was no need for blood transfusion or conversion to open surgery. Postoperative complications occurred in two patients. Mean hospital stay was 3.8 days. Conclusions: Hepatocellular adenoma should be regarded as an excellent indication for pure LLR. Pure LLR is safe and feasible and should be considered the standard of care for the treatment of HA when performed by surgeons with experience in liver and laparoscopic surgery.
- Hepatic Epithelioid Hemangioendothelioma: An Unusual Lesion of the Liver(2012) LUPINACCI, Renato Micelli; ROCHA, Manoel de Souza; HERMAN, Paulo
bookPart Cistos hepáticos(2012) PERINI, Marcos Vinicius; COELHO, Fabricio Ferreira; KRUGER, Jaime; HERMAN, Paulo; CECCONELLO, Ivan; ALBUQUERQUE, Luiz Augusto Carneiro; BRESCIANI, Claudio José Caldas; ZILBERSTEIN, BrunobookPart Adenoma hepático: novos conhecimentos e tratamento(2012) HERMAN, Paulo; COELHO, Fabricio Ferreira; KRUGER, Jaime P.; PERINI, Marcos V.- Prognostic factors for survival in patients with colorectal liver metastases: experience of a single brazilian cancer center(2012) RIBEIRO, Héber Salvador de Castro; STEVANATO-FILHO, Paulo Roberto; COSTA JR., Wilson Luiz da; DINIZ, Alessandro Landskron; HERMAN, Paulo; COIMBRA, Felipe José FernándezCONTEXT: Liver metastases are a common event in the clinical outcome of patients with colorectal cancer and account for 2/3 of deaths from this disease. There is considerable controversy among the data in the literature regarding the results of surgical treatment and prognostic factors of survival, and no analysis have been done in a large cohort of patients in Brazil. OBJECTIVES: To characterize the results of surgical treatment of patients with colorectal liver metastases, and to establish prognostic factors of survival in a Brazilian population. METHOD: This was a retrospective study of patients undergoing liver resection for colorectal metastases in a tertiary cancer hospital from 1998 to 2009. We analyzed epidemiologic variables and the clinical characteristics of primary tumors, metastatic disease and its treatment, surgical procedures and follow-up, and survival results. Survival analyzes were done by the Kaplan-Meier method and the log-rank test was applied to determine the influence of variables on overall and disease-free survival. All variables associated with survival with P<0.20 in univariate analysis, were included in multivariate analysis using a Cox proportional hazard regression model. RESULTS: During the period analyzed, 209 procedures were performed on 170 patients. Postope-rative mortality in 90 days was 2.9% and 5-year overall survival was 64.9%. Its independent prognostic factors were the presence of extrahepatic disease at diagnosis of liver metastases, bilateral nodules and the occurrence of major complications after liver surgery. The estimated 5-year disease-free survival was 39.1% and its prognostic factors included R1 resection, extrahepatic disease, bilateral nodules, lymph node involvement in the primary tumor and primary tumors located in the rectum. CONCLUSION: Liver resection for colorectal metastases is safe and effective and the analysis of prognostic factors of survival in a large cohort of Brazilian patients showed similar results to those pointed in international series. The occurrence of major postoperative complications appears to be able to compromise overall survival and further investigation in needed in this topic.