LENINE GARCIA BRANDAO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
Resultados de Busca
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- Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report(2014) LEITE, Ana K. N.; JUNIOR, Climerio P. do N.; ARAP, Sergio S.; MASSONI, Ledo; LOURENCO, Delmar M.; BRANDAO, Lenine Garcia; MONTENEGRO, Fabio L. de M.After a total parathyroidectomy, well-established protocols for the cryopreservation of parathyroid tissue and for the delayed autograft of this tissue exist, especially in cases of secondary hiperparathyroidism (HPT) or familial or sporadic parathyroid hyperplasia. Although delayed autografts are effective, the published success rates vary from 10% to 83%. There are numerous factors that influence the viability, and therefore the success, of an autograft, including cryopreservation time. Certain authors believe that the tissue is only viable for 24 months, but there is no consensus on how long the parathyroid tissue can be preserved. A 63-year-old male who was diagnosed with sporadic multiple endocrine neoplasia type 1 and primary hyperparathyroidism, and was submitted to a total parathyroidectomy and an autograft in the forearm. The implant failed, and the patient developed severe hypoparathyroidism in the months following the surgery. Thirty-six months after the total parathyroidectomy, the cryopreserved autograft was successfully transplanted, and hypoparathyroidism was reversed (most recent systemic parathyroid hormone, PTH, of 36 pg/mL, and total calcium of 9.1 mg/dL; no oral calcium supplementation). The case presented here indicates that cryopreserved parathyroid tissue may remain viable after 24 months in storage, and may retain the capacity to reverse permanent postsurgical hypoparathyroidism. These data provide reasonable evidence that the time limit for cryopreservation remains undetermined and that additional research would be valuable.
- Biometric measurements involving the terminal portion of the thoracic duct on left cervical level IV: an anatomic study(2016) LOUZADA, Andressa Cristina Sposato; LIM, Soo Jin; PALLAZZO, Jaqueline Fabiano; SILVA, Viviane Passarelli Ramin; OLIVEIRA, Ruan Vitor Silva de; YOSHIO, Alvaro Masahiro; ARAUJO-NETO, Vergilius Jose Furtado de; LEITE, Ana Kober Nogueira; SILVEIRA, Andre; SIMOES, Cesar; BRANDAO, Lenine Garcia; MATOS, Leandro Luongo de; CERNEA, Claudio RobertoTo determine the point of entrance of the thoracic duct in the venous system, as well as to evaluate some biometric measurements concerning its terminal portion, we conducted an anatomic study on 25 non-preserved cadavers. The termination of the thoracic duct occurred on the confluence between the left internal jugular vein and the left subclavian vein in 60 % of the individuals. The average results for the biometric measurements were: distance between the end of left internal jugular vein and omohyoid muscle 31.2 +/- A 2.7 mm; distance between the end of thoracic duct and the left internal jugular vein 0.0 +/- A 0.0 mm; distance between the end of thoracic duct and the left subclavian vein 3.6 +/- A 1.0 mm; distance between the end of thoracic duct and the left brachiocephalic vein 10.7 +/- A 3.1 mm. Moreover, it was identified that the left internal jugular vein length in level IV, measured between its entrance in the left subclavian vein and the omohyoid muscle, was able to predict the termination of the thoracic duct on the junction between the left internal jugular vein and the left subclavian vein (OR = 2.99) with high accuracy (79.3 %). In addition, the left internal jugular vein length at level IV was able to predict the localization of thoracic duct termination. Thus, this finding has practical value in minimizing the risk for a potential chyle leak during or after a left-sided neck dissection.
- Practical tips to reduce complication rate in thyroidectomy(2017) CERNEA, Claudio; BRANDAO, Lenine G.; HOJAIJ, Flavio C.; CARLUCCI, Dorival De; VANDERLEI, Felipe; GOTODA, Renato; LEITE, Ana K.; KULCSAR, Marco A. V.; MATOS, Leandro L.; DEDIVITIS, Rogerio A.; ARAUJO-FILHO, Vergilius J. F.; TAVARES, Marcos R.Introduction: Thyroid cancer is the most frequent endocrine neoplasm, and its incidence has been consistently rising during the last decades. Surgical treatment is the choice, but the complications can be truly devastating. Methods: The objective of this article is to present some practical tips to reduce the complication rate in thyroid surgery. Results: The more frequent complications during a thyroidectomy are mentioned, as well as practical tips to try to prevent them: acute airway compression, nerve injuries (both inferior laryngeal and external branch of the superior laryngeal nerves), and hypoparathyroidism. Conclusion: The prevention of complications during a thyroidectomy is imperative. The only way that the surgeon can assure the safety is to strictly adhere to technical principles, with diligent hemostasis, thorough anatomical knowledge, and gentle handling of the anatomic structures adjacent to the thyroid gland.
article 26 Citação(ões) na Scopus Pectoralis major myocutaneous flap for head and neck reconstruction: risk factors for fistula formation(2014) LEITE, A. K. N.; MATOS, L. L. De; BELLI, M.; KULCSAR, M. A. V.; CERNEA, C. R.; BRANDAO, L. Garcia; PINTO, F. R.The pectoralis major myocutaneous flap (PMMF) is a safe and versatile flap used widely for head and neck cancer reconstructions, but one of the major and most feared complications is oro- or pharyngocutaneous fistula. Herein, we attempt to establish risk factors for fistula formation in reconstructions of mucosal defects in the head and neck using PMMF through retrospective analysis of PMMF performed during 3 years at a single institution, with a total of 84 procedures. There were 69 men and 15 women, with a mean age of 59.5 years. There were 15 cases of partial flap loss, two total flap losses and 31 fistulas. The independent risk factors for fistula formation were preoperative serum hemoglobin <13 g/dl, preoperative serum albumin <3.4 g/dl and hypopharynx reconstruction. The PMMF is still a very useful flap and this is the first multivariate analysis analysing risk factors for fistula formation. These findings are helpful in selecting patients with elevated risk of fistula formation, and therefore preventive measures can be undertaken to avoid potentially serious complications.- Deaths related to differentiated thyroid cancer: a rare but real event(2017) LEITE, Ana Kober N.; CAVALHEIRO, Beatriz G.; KULCSAR, Marco Aurélio; HOFF, Ana de Oliveira; BRANDÃO, Lenine G.; CERNEA, Claudio Roberto; MATOS, Leandro L.ABSTRACT Objective The present study describes the clinical and tumor characteristics of patients that died from differentiated thyroid cancer and reports on the cause and circumstances of death in these cases. Subjects and methods Retrospective analysis of all the differentiated thyroid cancer (DTC) related deaths at a single institution over a 5-year period, with a total of 33 patients. Results Most of the patients were female (63.6%), with a mean age at diagnosis of 58.2 years. The most common histologic type was papillary (66.7%) and 30.3% were follicular. The distribution according to the TNM classification was: 15.4% of T1; 7.7% T2; 38.4% T3; 19.2% of T4a and 19.2% of T4b. Forty-four percent of cases were N0; 20% N1a and 36.6% of N1b. Twelve patients were considered non-responsive to radioiodine. Only one of the patients did not have distant metastases. The most common metastatic site was the lung in 69.7%. The majority of deaths were due to pulmonary complications related to lung metastases (17 patients, 51.5%), followed by post-operative complications in 5 cases, neurological disease progression in 3 cases, local invasion and airway obstruction in one patient. Median survival between diagnosis and death was reached in 49 months while between disease progression and death it was at 22 months. Conclusion Mortality from DTC is extremely rare but persists, and the main causes of death derive from distant metastasis, especially respiratory failure due to lung metastasis. Once disease progression is established, median survival was only 22 months.
- Surgical treatment for thyroid carcinoma: retrospective study with 811 patients in a Brazilian tertiary hospital(2016) CAVALHEIRO, Beatriz G.; MATOS, Leandro L.; LEITE, Ana Kober N.; KULCSAR, Marco Aurelio V.; CERNEA, Claudio R.; BRANDAO, Lenine G.Objective: The aim of the present study was to describe the epidemiologic data, histological type, treatment and follow-up of the 811 patients treated for thyroid cancer in Instituto do Cancer do Estado de Sao Paulo (ICESP) over 5 years. Materials and methods: Retrospective analyses of electronic chart information. Results: There were 679 cases (83.7%) of papillary thyroid cancer, 61 (7.5%) of follicular carcinoma, 54 (6.7%) of medullary carcinoma, 11 (1.4%) of poorly differentiated carcinoma and 6 of anaplastic carcinoma (0.7%). The majority of patients were female (82.2%), and the mean age was 50.5 +/- 15 years. Two hundred forty-two patients had disease persistence or recurrence. At the last follow-up, 629 (77.6%) patients were alive and disease free, 141 (17.4%) were alive with disease, and 41 (5.1%) were deceased, with 37 deaths related to thyroid cancer. Conclusion: This study was able to outline the profile, disease type and evolution of patients treated for thyroid cancer at a single tertiary hospital.