ESTHER MIHWA OH CHOI
Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Detecção de trombose venosa em retalhos livres por medidas de glicemia capilar(2012) MILLAN, Lincoln Saito; ISHIDA, Luiz Carlos; CHOI, Esther Mihwa Oh; GIACCHETTO JUNIOR, Enio Cesar; WEI, Teng Hsiang; MATTAR JÚNIOR, Rames; FERREIRA, Marcus CastroBACKGROUND: Monitoring of free flaps after surgery is vitally important, especially in the first few hours because the timing of reoperation can determine flap salvage or loss. To date, no study has examined the decision to reoperate on a flap based on the objective measure of glycemia or a comparison between flaps that showed good outcomes and those that showed vascular damage. The objective of this study was to evaluate the validity of blood glucose measurements within the flap as a method for monitoring free flaps and to compare the efficacy of this method with that of clinical assessments. METHODS: The study was prospective, included 16 patients with free flaps, and was conducted from May 2012 to July 2012. A team of professionals not involved in the surgery evaluated capillary glycemia. Flaps were clinically evaluated during the immediate postoperative period, on ICU admission, at every 3 hours, and as needed. RESULTS: Of the 16 patients, 5 (31.3%) had venous thrombosis in the first 24 hours. Statistically significant differences were noted in capillary glycemia in patients with or without venous thrombosis in measurements obtained 6, 9, and 12 hours after surgery (P < 0.05). CONCLUSIONS: The measurement of capillary glycemia was not superior to clinical evaluation by an experienced professional for the detection of venous thrombosis within free flaps.
- The Influence of the Superficial Venous System on DIEP Flap Drainage in Breast Reconstruction(2024) CHOI, Esther Mihwa Oh; RIBEIRO, Renan Diego Americo; MONTAG, Eduardo; UEDA, Thiago; OKADA, Alberto Yoshikazu; MUNHOZ, Alexandre Mendonca; BUSNARDO, Fabio de Freitas; GEMPERLI, RolfBackground Autologous tissue has become the gold standard in breast reconstruction. The use of a deep inferior epigastric perforator (DIEP) flap has the advantages of giving a natural appearance to the reconstructed breast and being associated with lower morbidity at the donor site when compared with the transverse rectus abdominis myocutaneous flap. Venous complications such as venous thrombosis and insufficiency remain the main causes of flap loss and surgical revisions. The aim of this study was to evaluate the influence of superficial venous drainage of the DIEP flap and the addition of a second venous anastomosis have on flap survival.Methods This was a retrospective cohort study collected from a prospective database maintained by our institution. Data was obtained from the medical records of female patients who underwent mastectomy and breast reconstruction with a DIEP flap between March 2010 and March 2017. We evaluated 137 DIEP patients with unilateral breast reconstructions. In 64 (46.7%) the deep venous system was chosen and 73 (53.3%) had an additional superficial vein anastomosed.Results Out of the 137 patients evaluated, there were 16 (11.67%) cases of revision, 14 (10.21%) were due to venous thrombosis. Twelve cases (8.75%) of flap loss were reported. Reoperation rate was lower in the dual venous drainage group when compared with the single venous drainage group ( p = 0.005), as was the rate of flap loss ( p = 0.006) and reoperation due to venous thrombosis ( p = 0.002). Out of the 125 DIEP flaps, fat necrosis was clinically identified in 7 (5.1%) cases, and the rate was lower in the dual venous drainage system group ( p = 0.01).Conclusion Dual venous drainage of a DIEP flap appears to reduce the rates of venous thrombosis, reoperation, total flap loss, and fat necrosis.