DENIS PAJECKI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

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    ROBOTIC-ASSISTED REVISIONAL ROUX-EN-Y GASTRIC BYPASS FOR LARGE HIATAL HERNIA AND MASSIVE INTRATHORACIC SLEEVE MIGRATION
    (2023) SANTO FILHO, Marco Aurelio; DANTAS, Anna Carolina Batista; ARABI, Arthur Youssif Mota; PAJECKI, Denis; SANTO, Marco Aurelio
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    LACTATE AS MARKER OF METABOLIC SYNDROME IN SEVERE OBESITY Basic science and research in bariatric surgery
    (2019) VIEIRA, A. Gadducci; CARDIA, L.; OLIVEIRA, F. Costa De; MARIA, J. Greve De; SANTOS, P. Silva Roberto; PAJECKI, D.; AURELIO, M. Santo; CLEVA, R. De
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    LIVER FUNCTION IMPROVEMENT AFTER BARIATRIC SURGERY: USING THE INDOCYANINE GREEN TEST IN THE FOLLOW-UP OF OBESE PATIENTS NASH and bariatric surgery
    (2019) SILVA, M. B. D. B. E.; MESQUITA, G. H. A. D.; DANTAS, A. C. B.; MOTA, F. C.; KAWAMOTO, F. M.; PAJECKI, D.; RICCIOPPO, D.; CLEVA, R. D.; ANDRAUS, W.; SANTO, M. A.; CECCONELLO, I.
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    Assessment of Body Composition in Morbid Obesity: a Comparative Study Between Body Impedance and Adiposity index Methods
    (2012) SANTO, M. A.; RICCIOPPO, D.; PAJECKI, D.; KAWAMOTO, F.; MATSUDA, M.; CECCONELLO, I
    Introduction Obesity has become an epidemic public health problem. A reliable method to assess body composition and monitor the effectiveness of treatments for the morbid obesity is mandatory. However, there is still controversy as to which method to use for this purpose. Two Methods are validated in the literature, bioelectrical impedance analysis (BIA) and body adiposity index (BAI). The present study compared these methodologies. Materials & Methods We evaluated 167 patients undergoing bariatric surgery, women prevailed (82.59 %), averaging 44 years-old and mean BMI of 49.48 kg/m2. Weight, height and hip circumference were measured. Body fat (BF) was calculated by BIA and BAI. The following formulas were used: BIA: BF in kg=023.25+(0.09x resistance in ohms)+(1.00x weight in kg)-(0.08xheight in cm)+(0.13x age in years). BAI: BF% of the total weight 0 (hip circumference in centimeters/height in meters x height in meters)-18. Results The patients had an average of 53.35 % (± 5.37) of BF according to BIA, and BAI showed 50.51 % (± 13.59) of BF. There is no difference between the two Methods (p<0,05), even when stratified by BMI (BMI<45, 4550). Essa diferença variou quando o IMC foi dividido em três faixas, abaixo de 45 kg/m2 a diferença foi de 3,1 %, entre 45,1 a 49,99 kg/m2 a diferença foi de 3,78 %, acima de 50 kg/m2 a diferença foi de 1,86%. Discussion The BAI is a simple method of implementation, low cost and effective, when compared to other Methods validated for morbidly obese patients. Conclusion BAI is an effective method to assess BF, comparable to BIA, and also proved to be effective in super obese patients.
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    Preoperative Weight Loss in Super Obesity: Influence on Perioperative Morbidity and Mortality in Patients undergoing Gastric Bypass
    (2012) SANTO, M. A.; RICCIOPPO, D.; PAJECKI, D.; KAWAMOTO, F.; MATSUDA, M.; CECCONELLO, I
    Introduction Super obesity (SO) is increasing in greater proportions, and now represents 30 % of morbidly obese patients. In SO morbidity and mortality rates are greater. The preoperative weight loss in SO decreases operative time, and apparently diminishes morbidity. Based on these data, we initiated a program of preoperative weight loss for the SO. The treatment is based on hospitalization, low-calorie diet, biometrics control and physical activities, aiming to analyze weight loss and influence of weight loss in the perioperative outcome. Materials & Methods Thirty patients underwent our SO preop weight loss program, from 2006 to 2011. The mean age was 46 years, and mean BMI of 66 kg/m2 and the majority was female. All patients underwent gastric bypass after the weight loss. The average caloric intake was 5 cal/Kg/day. Results The mean weight loss was 1.9 kg/week, and after 14 weeks the mean weight loss was15.2 % of initial weight. The mean hospital stay was 21.3 weeks, and the mean weight loss was 19.7 %. All had satisfactory recovery from surgery. The mortality was null. In the last five years, from the total of 592 surgeries, 193 was performed in SO. The SO and general morbidity was 11.14 % and 20.2 %, respectively, and mortality 0.84 % and 2.07 %. Discussion In SO a preoperative weight loss is an important tool to reduce surgical risks. Hospitalization, with low-calorie diet and multidisciplinary follow-up is a safe and effective way to achieve weight loss preoperatively. Conclusion After a mean of 19,7 % of initial body weight loss, the studied group showed an important decreasing in morbimortality when compared with our previous experience. Preoperative weight loss should be encouraged in SO, and a specific program can significantly diminish surgical risks in this complex group of obeses.
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    LAPAROSCOPIC SLEEVE GASTRECTOMY AFTER LIVER TRANSPLANTATION - VL.071
    (2014) PAJECKI, D.; SANTO, M.; JOAQUIM, H. D.; KAWAMOTO, F.; CESCONETTO, D.; MACACARI, R.; ANDRAUS, W.; D'ALBUQUERQUE, L. C.; CECCONELLO, I.
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    LATE POSTOPERATIVE OUTCOME OF ROUX-EN-Y GASTRIC BYPASS IN MORBIDLY OBESE PATIENTS - ANALYSIS OF THE INFLUENCE OF GASTROINTESTINAL HORMONES IN WEIGHT REGAIN
    (2015) SANTO, Marco; RICCIOPPO, Daniel; PAJECKI, Denis; KAWAMOTO, Flavio; JOAQUIM, Henrique; CLEVA, Roberto; ANTONANGELO, Leila; MARCAL, Lia; GARMS, Alan; CECCONELLO, Ivan
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    LAPAROSCOPIC TREATMENT OF OPEN GASTRIC BYPASS RING SLIPPAGE: GASTRIC POUCH REDO
    (2014) PAJECKI, D.; SANTO, M.; KAWAMOTO, F.; JOAQUIM, H. D.; CESCONETTO, D.; MACACARI, R.; CECCONELLO, I.
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    ROBOTIC REVISIONAL GASTRIC BYPASS: POUCH ""REDO"" AND HIATAL HERNIA REPAIR
    (2015) PAJECKI, Denis; SANTO, Marco Aurelio; PUZZO, Daniel Bauab; JOAQUIM, Henrique; RICCIOPPO, Daniel
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    FALL PREVALENCE AND BONE METABOLISM IN OBESE ELDERLY PATIENTS UNDERGOING BARIATRIC SURGERY
    (2016) SANTO, M. A.; KANAJI, A. L.; ANDRADE, J. P.; PAJECKI, D.; CLEVA, R. de