GABRIEL CARVALHO DOS ANJOS SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Single-stage Abdominoplasty Using Groin Flaps Without Osteotomies: Management of Exstrophy-epispadias Complex(2018) GIRON, Amilcar Martins; MELLO, Marcos Figueiredo; BERJEAUT, Ricardo Haidar; MACHADO, Marcos Giannetti; SILVA, Gabriel Carvalho dos Anjos; CEZARINO, Bruno Nicolino; OLIVEIRA, Lorena Marcalo; LOPES, Roberto Iglesias; DENES, Francisco TiborBACKGROUND The optimal treatment for children born with exstrophy-epispadia complex is still a matter of AND OBJECTIVE debate.(1,2,3) We demonstrate the Single-Stage Abdominoplasty using Groin Flap technique to close the abdominal wall of children with classic bladder exstrophy (CBE) without osteotomy neither radical soft tissue mobilization. Advantages over current techniques are less risk of penile tissue loss and avoidance of osteotomies. MATERIAL AND METHODS Abdominal wall repair consists in using the hypogastric skin, rectus, and obliquus externus abdom inalis muscle fascial flaps. These groin flaps are rotated medially resulting in a very strong abdominal wall support. Groin flaps are made of rectus anterior fascia rotated medially, flipped over, and sutured with Prolene sutures to close the defect. By rotating the fascial flaps medially, complete reinforcement of the abdominal wall to the level of the pubic bone is achieved. This permits abdominal closure maintenance without tension. RESULTS Groin flap was applied to 128 patients with CBE referenced from all over the country. Most of these patients returned to their home areas making difficult their follow up. However, we have 44 cases that have regular clinical visits. Mean follow-up was 10.3 4.5 years (2 years 8 months-16 years). Successful closure was achieved in 43 patients (97.7%) as a single procedure; one patient had a complete wound dehiscence and needed another reconstruction (2.2%). Four patients (9.1%) presented abdominal hernias that needed surgical management. When continence is evaluated, we present similar literature rates (60%).(4) CONCLUSION Abdominal reconstruction using Groin flaps has advantages over the traditional approaches to CBE. It reduces the surgical steps and facilitates the closure of the abdominal wall without the need of osteotomies and consequent immobilization during the postoperative period. It is feasible at any age and can be also very useful as a salvage technique even after previous failed procedures. Finally, it minimizes the number of surgeries. (C) 2018 Elsevier Inc.
- The use of statins is related to a lower PSA level after endoscopic enucleation of the prostate with holmium laser (HoLEP) for the treatment of BPH(2023) SUARTZ, Caio Vinicius; BRAZ, Natalia Doratioto Serrano Faria; ANJOS, Gabriel Carvalho dos; REIS, Sabrina Thalita dos; NAHAS, William Carlos; ANTUNES, Alberto AzoubelObjectiveTo determine the factors that may be associated with a 2-month high baseline level of Total Prostatic Specific Antigen (PSA) after endoscopic enucleation of the prostate with Holmium Laser (HoLEP).Materials and methodsRetrospective study of a prospectively collected database of adult males undergoing HoLEP at a single tertiary institution from September 2015 to February 2021. Pre-operative epidemiological, clinical characteristics and post-operative factors were analyzed and a multivariate analysis was performed to determine factors independently related to PSA decline.ResultsA total of 175 men aged 49-92 years with a prostate size ranging from 25 to 450 cc underwent HoLEP, and after excluding data from patients due to loss of follow-up or incomplete data, 126 patients were included in the final analysis. The patients were divided into group A (n = 84), which included patients with postoperative PSA nadir lower than 1 ng/ml, and group B(n = 42), with postoperative PSA levels greater than 1 ng/ml. In the univariate analysis there was a correlation between the variation of the PSA value and the percentage of resected tissue (p = 0.028), for each 1 g of resected prostate there was a reduction of 0.104 ng/mL, furthermore there was a difference between the means of age of group A (71.56 years) and group B (68.17 years) (p = 0.042). In the multivariate analysis, the use of statins and lower postoperative PSA levels (p = 0.024; HR = 3.71) were correlated.ConclusionsOur results indicate that PSA after HoLEP is correlated with patient's age, the presence of incidental prostate cancer, and the use of statins.
- A Prospective, Randomized Trial Comparing the Outcomes of Open vs Laparoscopic Partial Nephrectomy(2022) GUGLIELMETTI, Giuliano B.; ANJOS, Gabriel C. dos; SAWCZYN, Guilherme; RODRIGUES, Gilberto; CARDILI, Leonardo; CORDEIRO, Mauri Prime Cio D.; NEVES, Luiz C. O.; PONTES JUNIOR, Jose; FAZOLI, Arnaldo; COELHO, Rafael F.; SROUGI, Miguel; NAHAS, William C.Purpose: Partial nephrectomy is the standard treatment for renal tumors <7 cm, and the trend toward minimally invasive surgery has increased. However, data that could support its use and benefits are still lacking. Materials and Methods: We conducted a prospective, randomized controlled trial comparing surgical, functional and oncologic outcomes in patients undergoing open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN). Randomization was 1:1 to OPN or LPN for the treatment of renal tumors <7 cm. The primary endpoint was surgical complications up to 90 days after surgery. Secondary outcomes were comparison of surgical, oncologic and functional results. Results: We randomized 208 patients between 2012 and 2020 (110 with OPN vs 98 with LPN). Operative data showed no differences in operative time, warm ischemia time, estimated blood loss, transfusions or length of hospital stay. Zero ischemia was more frequent in the OPN (35.4% vs 15.5%, p=0.02). OPN was associated with more abdominal wall complications (31.2% vs 13.1%, p=0.004). Regarding oncologic outcomes, no differences were noted. The LPN group had less kidney function reduction at 3 (-5.2% vs -10%, p=0.04; CI 0.09 to 9.46) and 12 months after surgery (-0.8% vs -6.3%, p=0.02; CI 1.18 to 12.95), and a lower rate of downstaging on the chronic kidney disease classification at 12 months (14.1% vs 32.6%, p=0.006). Conclusions: Surgical and oncologic outcomes of LPN were similar to OPN. Minimally invasive surgery may provide better preservation of kidney function. More studies, especially those involving robotic surgery, are necessary to confirm our findings.
- A Prospective, Randomized Trial Comparing the Outcomes of Open vs Laparoscopic Partial Nephrectomy. Reply.(2023) ANJOS, Gabriel C. Dos; GUGLIELMETTI, Giuliano B.; JUNIOR, Jose P.; CORDEIRO, Mauricio; COELHO, Rafael F.; NAHAS, William C.
- Reply by Authors(2022) GUGLIELMETTI, G. B.; ANJOS, G. C. Dos; SAWCZYN, G.; RODRIGUES, G.; CARDILI, L.; CORDEIRO, M. D.; NEVES, L. C. O.; PONTES JUNIOR, J.; FAZOLI, A.; COELHO, R. F.; SROUGI, M.; NAHAS, W. C.
- REPLY BY THE AUTHORS: RE: Impact of COVID-19 on a urology residency program(2021) DANILOVIC, Alexandre; TORRICELLI, Fabio Cesar Miranda; ANJOS, Gabriel dos; CORDEIRO, Mauricio Dener; MACHADO, Marcos Giannetti; SROUGI, Miguel; NAHAS, William C.
- Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil(2021) NETO, Rubens Pedrenho; NASCIMENTO, Bruno C. G.; SILVA, Gabriel Carvalho dos Anjos; BARBOSA, Joao Arthur Brunhara Alves; BESSA JUNIOR, Jose de; TEIXEIRA, Thiago Afonso; SROUGI, Miguel; NAHAS, William Carlos; HALLAK, Jorge; CURY, JoseIntroduction: The pandemic caused by the COVID-19 resulted in worldwide social isolation and lead-ing to significant personal distress, particularly among health professionals on the front lines. Those factors' relevance and their impact on sexual function in this population have not yet been established. Aim: To evaluate the impact of the pandemic on sexual function in healthcare professionals and medical students at a reference center in the treatment of COVID-19 in Brazil. Methods: A cross-sectional analysis with online questionnaires about sexual function was sent to health profes-sionals and medical students from the HC-FMUSP medical complex. The questionnaire evaluated Total Sexual and Masturbatory Frequency prior and during the pandemic, libido and sexual satisfaction changes with a detailed inquire about demographics and personal factors. An objective assessment of sexual function was also made using the validated sexual quotient questionnaires. Main Outcome Measures: Differences in intercourse frequency, libido, and overall sexual satisfaction, in a sample of healthcare professionals particularly vulnerable to the pandemic effects. Results: A total of 1,314 responses were available with a mean age of 37 years. Worsening of sexual satisfaction was reported by 44.5% of the participants, with the following associated factors: Lower libido, missing Nightlife, Higher Masturbatory Frequency, and isolation from the partner. Remaning sexualy actively and having higher sexual frequency appear to decrease the chance of worsening sexual function. Worsening of Libido was reported by 37% and had several associated factors, including missing of Nightlife, older age, isolation from the partner among others. Being male and sexually active was associated with a smaller chance of reporting lower libido. Conclusion: We were able to observe a sharp drop in Libido and General Sexual Satisfaction. Although an increase in pornography consumption and masturbatory frequency did occur, these factors were not associated with greater sexual satisfaction. The impact of COVID-19 on this population's sexual health is not to be underes-timated and should be further studied in the follow-up of the pandemic.
conferenceObject Is partial cistectomy safe for non-urologic malignant tumors invading bladder wall? A ten year follow-up report(2021) ANJOS, Silva G. dos; ABE, D. K.; BATISTA, F. F. A.; NUNES, R. S.; AREAS, F. G. M.; CORDEIRO, M. D.; COELHO, R. F.; NAHAS, W. C.- Evaluation of uro-oncological surgical treatment during the Sars-CoV-2 pandemic in a Brazilian tertiary oncology institution, the new world epicenter(2021) SILVA, Gabriel Carvalho dos Anjos; ABE, Daniel Kanda; NETO, Rubens Pedrenho; VILARES, Rafael Nascimento; CORDEIRO, Mauricio Dener; COELHO, Rafael Ferreira; NAHAS, William CarlosIntroduction: The rapid spread of coronavirus disease 2019 (COVID-19) has dramatic effects on individuals and health care systems. In our institute, a tertiary oncologic public hospital with high surgical volume, we prioritize maintaining cancer treatment as well as possible. The aim of this study is to evaluate if uro-oncological surgeries at pandemic are safe. Materials and Methods: We evaluated patients who underwent uro-oncological procedures. Epidemiological data, information on COVID-19 infection related to surgery and clinical characteristics of non-survival operative patients with COVID-19 infections were analyzed. Results: From 213 patients analyzed, Covid-19 symptoms were noticed in 8 patients at preoperative process or at hospital admission postponing operation; 161 patients were submitted to elective surgery and 44 to emergency surgery. From patients submitted to elective surgeries, we had 1 patient with laboratory confirmation of COVID-19 (0,6%), with mild symptoms and quick discharge. From the urgencies group, we had 6(13%) patients tested positive; 5 were taken to ICU with 4 deaths. Conclusion: Elective uro-oncological procedures at the COVID-19 epidemic period in a COVID-19-free Institute are safe, and patients who need urgent procedures, with a long period of hospitalization, need special care to avoid COVID-19 infection and its outcomes.
- Impact of COVID-19 on a urology residency program(2021) DANILOVIC, Alexandre; TORRICELLI, Fabio Cesar Miranda; ANJOS, Gabriel dos; CORDEIRO, Mauricio Dener; MACHADO, Marcos Giannetti; SROUGI, Miguel; NAHAS, William C.