RICARDO ZUGAIB ABDALLA

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico

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Autor: ABDALLA, Ricardo Zugaib ×

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  • article 6 Citação(ões) na Scopus
    Short-Term Surgical Outcomes of Robotic Gastrectomy Compared to Open Gastrectomy for Patients with Gastric Cancer: a Randomized Trial
    (2022) RIBEIRO, Ulysses; DIAS, Andre Roncon; RAMOS, Marcus Fernando Kodama Pertille; YAGI, Osmar Kenji; OLIVEIRA, Rodrigo Jose; PEREIRA, Marina Alessandra; ABDALLA, Ricardo Zugaib; ZILBERSTEIN, Bruno; NAHAS, Sergio Carlos; CECCONELLO, Ivan
    Background Robotic gastrectomy (RG) has been shown to be a safe and feasible method in gastric cancer (GC) treatment. However, most studies are in Eastern cohorts and there is great interest in knowing whether the method can be used routinely, especially in the West. Objectives The aim of this study was to compare the short-term surgical outcomes of D2-gastrectomy by RG versus open gastrectomy (OG). Methods Single-institution, open-label, non-inferiority, randomized clinical trial performed between 2015 and 2020. GC patients were randomized (1:1 allocation) to surgical treatment by RG or OG. Da Vinci Si platform was used. Inclusion criteria: gastric adenocarcinoma, stage cT2-4 cNO-1, potentially curative surgery, age 18-80 years, and ECOG performance status 0-1. Exclusion criteria: emergency surgery and previous gastric or major abdominal surgery. Primary endpoint was short-term surgical outcomes. The study is registered at clinicaltrials.gov (NCT02292914). Results Of 65 randomized patients, 5 were excluded (3 palliatives, 1 obstruction and emergency surgery, and 1 for material shortage). Consequently, 31 and 29 patients were included for final analysis in the OG and RG groups, respectively. No differences were observed between groups regarding age, sex, BMI, comorbidities, ASA, and frequency of total gastrectomy. RG had similar mean number of harvested lymph nodes (p = 0.805), longer surgical time (p < 0.001), and less bleeding (p <0.001) compared to OG. Postoperative complications, length of hospital stay, and readmissions in 30 days were equivalent between OG and RG. Conclusions RG reduces operative bleeding by more than 50%. The short-term outcomes were non-inferior to OG, although surgical time was longer in RG.
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  • article 1 Citação(ões) na Scopus
    ROBOTIC-ASSISTED VERSUS LAPAROSCOPIC INCISIONAL HERNIA REPAIR: DIFFERENCES IN DIRECT COSTS FROM A BRAZILIAN PUBLIC INSTITUTE PERSPECTIVE
    (2022) COSTA, Thiago Nogueira; TUSTUMI, Francisco; FERROS, Lucas Sousa Maia; COLONNO, Barbara Buccelli; ABDALLA, Ricardo Zugaib; JR, Ulysses Ribeiro; CECCONELLO, Ivan
    Background: Robotic-assisted surgery research has grown dramatically in the past two decades and the advantages over traditional videolaparoscopy have been extensively debated. For hernias, the robotic system can increase intraoperative strategies, especially in complex hernias or incisional hernias.Aims: This study aimed to compare the direct cost differences between robotic and laparoscopic hernia repair and determine each source of expenditure that may be related to the increased costs in a robotic program from the perspective of a Brazilian public institution.Methods: This study investigated the differences in direct costs from the data generated from a trial protocol (ReBEC: RBR-5s6mnrf). Patients with incisional hernia were randomly assigned to receive laparoscopic ventral incisional hernia repair (LVIHR) or robotic ventral incisional hernia repair (RVIHR). The direct medical costs of hernia treatment were described in the Brazilian currency (R$).Results: A total of 19 patients submitted to LVIHR were compared with 18 submitted to RVIHR. The amount spent on operation room time (RVIHR: 2,447.91 +/- 644.79; LVIHR: 1,989.67 +/- 763.00; p=0.030), inhaled medical gases in operating room (RVIHR: 270.57 +/- 211.51; LVIHR: 84.55 +/- 252.34; p=0.023), human resources in operating room (RVIHR: 3,164.43 +/- 894.97; LVIHR: 2,120.16 +/- 663.78; p<0.001), material resources (RVIHR: 3,204.32 +/- 351.55; LVIHR: 736.51 +/- 972.32; p<0.001), and medications (RVIHR: 823.40 +/- 175.47; LVIHR: 288.50 +/- 352.55; p<0.001) for RVIHR was higher than that for LVIHR, implying a higher total cost to RVIHR (RVIHR: 14,712.24 +/- 3,520.82; LVIHR: 10,295.95 +/- 3,453.59; p<0.001). No significant difference was noted in costs related to the hospital stay, human resources in intensive care unit and ward, diagnostic tests, and meshes.Conclusion: Robotic system adds a significant overall cost to traditional laparoscopic hernia repair. The cost of the medical and robotic devices and longer operative times are the main factors driving the difference in costs.
  • bookPart
    Telas - Implantes Sintéticos para a Parede Abdominal
    (2013) ABDALLA, Ricardo Zugaib
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    Paraestomais
    (2013) ABDALLA, Ricardo Zugaib
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    Correção de Hérnia Incisional Ventral por Videocirurgia
    (2013) ABDALLA, Ricardo Zugaib
  • article 10 Citação(ões) na Scopus
    Robotic-assisted compared with laparoscopic incisional hernia repair following oncologic surgery: short- and long-term outcomes of a randomized controlled trial
    (2023) COSTA, Thiago Nogueira; ABDALLA, Ricardo Zugaib; TUSTUMI, Francisco; RIBEIRO JR., Ulysses; CECCONELLO, Ivan
    Background Patients with abdominal site cancer are at risk for incisional hernia after open surgery. This study aimed to compare the short- and long-term outcomes of robotic-assisted (RVIHR) with the laparoscopic incisional hernia repair (LVIHR) in an oncologic institute. Methods This is a single-blinded randomized controlled pilot trial. Patients were randomized into two groups: RVIHR and LVIHR. Results Groups have similar baseline characteristics (LVIHR: N = 19; RVIHR: N = 18). No difference was noted in the length of hospital stay (RVIHR: 3.67 +/- 1.78 days; LVIHR: 3.95 +/- 2.66 days) and postoperative complications (16.7 versus 10.5%; p = 0.94). The mean operating time for RVIHR was significantly longer than LVIHR (RVIHR was 355.6 versus 293.5 min for LVIHR; p = 0.04). Recurrence was seen in three patients in LVIHR and two in RVIHR at 24-month follow-up, with no significant difference. (p > 0.99). Conclusion Laparoscopic and robotic-assisted incisional hernia repair show similar short- and long-term outcomes for cancer patients.
  • bookPart
    Hérnia Inguinal Laparoscópica Pré-Peritoneal Transabdominal (TAPP)
    (2013) GARCIA, Rodrigo Biscuola; ABDALLA, Ricardo Zugaib
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    Implantes Sintéticos para Parede Abdominal
    (2013) ABDALLA, Ricardo Zugaib
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    Correção de Hérnia Inguinocrural por Acesso Extraperitoneal
    (2013) COSTA, Rafael Izar Domingues da; ABDALLA, Ricardo Zugaib