FERNANDO IDE YAMAUCHI
Índice h a partir de 2011
9
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Renal Stone Features Are More Important Than Renal Anatomy to Predict Shock Wave Lithotripsy Outcomes: Results from a Prospective Study with CT Follow-Up(2020) TORRICELLI, Fabio C. M.; MONGA, Manoj; YAMAUCHI, Fernando I.; MARCHINI, Giovanni S.; DANILOVIC, Alexandre; VICENTINI, Fabio C.; BATAGELLO, Carlos A.; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoIntroduction: Lower pole kidney stones have been associated with poor shock wave lithotripsy (SWL) outcomes because of its location. However, the real impact of collecting system anatomy on stone clearance after SWL is uncertain. There is a lack of prospective well-controlled studies to determine whether lower pole kidney stones have inferior outcomes than nonlower pole kidney stones when treated with SWL. Methods: We prospectively evaluated patients with a single kidney stone of 5-15mm undergoing SWL from June 12 through January 19. All patients were subjected to computed tomography before and 3 months after the procedure. Demographic data (age, gender, and body mass index), stone features (stone size, stone area, stone density, and stone-skin distance-SSD), and collecting system anatomy (infundibular length and width, and infundibulopelvic angle) were recorded. Outcomes (fragmentation and stone clearance rates) were compared between lower pole and nonlower pole cases. Then, a multivariate analysis including all variables was performed to determinate which parameters significantly impact on SWL outcomes. Results: One hundred and twenty patients were included in the study. Mean stone size was 8.3mm and mean stone density was 805 Hounsfield units. Overall stone fragmentation, success, and stone-free rates were 84.1%, 64.1%, and 34.1%, respectively. There were no significant differences in stone fragmentation (76.0% vs 71.4%; p=0.624), success rate (57.6% vs 53.3%; p=0.435), and stone-free rate (40.2% vs 35.7%; p=0.422) in the lower vs nonlower pole groups, respectively. On multivariate analysis, only stone density (p<0.001) and SSD (p=0.006) significantly influenced fragmentation. Stone size (p=0.029), stone density (p=0.002), and SSD (p=0.049) significantly influenced kidney stone clearance. Conclusions: Stone size, stone density, and SSD impact on SWL outcomes. Lower pole kidney stones have similar fragmentation and stone clearance compared with nonlower pole kidney stones.
conferenceObject A NEW INSIGHT FOR THE TREATMENT OF PRIMARY MACRONODULAR ADRENAL HYPERPLASIA: ADRENAL SPARING SURGERY EARLY OUTCOMES(2019) TANNO, Fabio; FRAGOSO, Maria Candida B. V.; SROUGI, Victor; ALMEIDA, Madson Queiroz; MENDONCA, Berenice Bilharinho; YAMAUCHI, Fernando Ide; MORBECK, Fernando; NAHAS, Willian Carlos; SROUGI, Miguel; CHAMBO, Jose Luis- Impact of Renal Anatomy on Shock Wave Lithotripsy Outcomes for Lower Pole Kidney Stones: Results of a Prospective Multifactorial Analysis Controlled by Computerized Tomography(2015) TORRICELLI, Fabio C. M.; MARCHINI, Giovanni S.; YAMAUCHI, Fernando I.; DANILOVIC, Alexandre; VICENTINI, Fabio C.; SROUGI, Miguel; MONGA, Manoj; MAZZUCCHI, EduardoPurpose: We evaluated which variables impact fragmentation and clearance of lower pole calculi after shock wave lithotripsy. Materials and Methods: We prospectively evaluated patients undergoing shock wave lithotripsy for a solitary 5 to 20 mm lower pole kidney stone between June 2012 and August 2014. Patient body mass index and abdominal waist circumference were recorded. One radiologist blinded to shock wave lithotripsy outcomes measured stone size, area and density, stone-to-skin distance, infundibular length, width and height, and infundibulopelvic angle based on baseline noncontrast computerized tomography. Fragmentation, success (defined as residual fragments less than 4 mm in asymptomatic patients) and the stone-free rate were evaluated by noncontrast computerized tomography 12 weeks postoperatively. Univariate and multivariate analysis was performed. Results: A total of 100 patients were enrolled in the study. Mean stone size was 9.1 mm. Overall fragmentation, success and stone-free rates were 76%, 54% and 37%, respectively. On logistic regression body mass index (OR 1.27, 95% CI 1.11-1.49, p = 0.004) and stone density (OR 1.0026, 95% CI 1.0008-1.0046, p = 0.005) significantly impacted fragmentation. Stone size (OR 1.24, 95% CI 1.07-1.48, p = 0.039) and stone density (OR 1.0021, 95% CI 1.0007-1.0037, p = 0.012) impacted the success rate while stone size (OR 1.24, 95% CI 1.04-1.50, p = 0.029), stone density (OR 1.0015, 95% CI 1.0001-1.0032, p = 0.046) and infundibular length (OR 1.1035, 95% CI 1.015-1.217, p = 0.015) impacted the stone-free rate. The best outcomes were found in patients with a body mass index of 30 kg/m(2) or less, stones 10 mm or less and 900 HU or less, and an infundibular length of 25 mm or less. The coexistence of significant unfavorable variables led to a stone-free rate of less than 20%. Conclusions: Obese patients with higher than 10 mm density stones (greater than 900 HU) in the lower pole of the kidney with an infundibular length of greater than 25 mm should be discouraged from undergoing shock wave lithotripsy.
- Complete Calcified Ureteral Stent: A Combined 1-Session Approach(2017) TORRICELLI, Fabio C. M.; BERJEAUT, Ricardo H.; LAFFEIRA, Luccas; YAMAUCHI, Fernando I.; MARCHINI, Giovanni S.; NAHAS, William C.; SROUGI, Miguel; MAZZUCCHI, EduardoOBJECTIVE To demonstrate a successful 1-session approach to a complete calcified ureteral stent, preserving the affected kidney without complications. PATIENT AND METHODS A 33-year-old man presented at our service with an increased urinary frequency, afebrile urinary tract infection, and left lumbar pain. He underwent a ureterolithotripsy with ureteral stenting 3 years ago. After that intervention, he was lost to follow-up. A noncontrast computed tomography scan revealed a complete calcified ureteral stent (FECal V). After careful preoperative planning, the patient was submitted to a combined 1-step approach including left semirigid ureteroscopy, left percutaneous nephrolithotomy, and an open cystolithotomy in supine decubitus. This video demonstrates the surgical steps of the procedure for a FECal V (completely calcified) stent removal. RESULTS Operative time was 240 minutes. The calcified stent was completely removed. A 6 Fr ureteral catheter and a 16 Fr nephrostomy tube were left at the end of the procedure. No double-J stent was used to avoid the same kind of complication. The patient had no peri-or postoperative complications. A computed tomography scan was performed in the first postoperative day (POD) and revealed 2 small residual fragments (7 mm and 6 mm). The ureteral catheter was removed on the first POD, and the nephrostomy tube on the second POD. The patient was discharged from hospital on the third POD. The patient is now scheduled to a flexible ureteroscopy to treat the small residual fragments. CONCLUSION Forgotten ureteral stent is a surgical challenge, requiring multiple approaches and advanced urologic techniques. Our video illustrates that a less invasive and combined 1-step procedure to preserve the kidney is both safe and feasible, when performed by an experienced surgeon. (C) 2017 Elsevier Inc.
- Extensive renal sinus lipomatosis in xanthogranulomatous pyelonephritis simulating liposarcoma(2018) ANDO, Sabrina de Mello; MORENO, Raquel Andrade; VIANA, Publio Cesar Cavalcante; YAMAUCHI, Fernando IdeRenal replacement lipomatosis is a condition characterized by varying degrees of renal parenchymal atrophy and perirenal fibrofatty proliferation secondary to chronic inflammation such as xanthogranulomatous pyelonephritis. In severe cases, imaging findings can be misdiagnosed as retroperitoneal liposarcoma.
conferenceObject RENAL STONE FEATURES ARE MORE IMPORTANT THAN RENAL ANATOMY TO PREDICT SHOCK WAVE LITHOTRIPSY OUTCOMES: RESULTS FROM A PROSPECTIVE STUDY WITH CT FOLLOW-UP(2020) TORRICELLI, Fabio; MONGA, Manoj; YAMAUCHI, Fernando; MARCHINI, Giovanni; DANILOVIC, Alexandre; VICENTINI, Fabio; BATAGELLO, Carlos; SROUGI, Miguel; NAHAS, William; MAZZUCCHI, Eduardo