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
20 resultados
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- Delayed postoperative radiation therapy in local control of squamous cell carcinoma of the tongue and floor of the mouth(2014) AMAR, Ali; CHEDID, Helma Maria; CURIONI, Otávio Alberto; DEDIVITIS, Rogério Aparecido; RAPOPORT, Abrão; CERNEA, Claudio Roberto; BRANDÃO, Lenine GarciaObjective To evaluate the effect of time between surgery and postoperative radiation therapy on local recurrence of squamous cell carcinoma of the tongue and floor of the mouth. Methods A total of 154 patients treated between 1996 and 2007 were selected considering local recurrence rate and time of the adjuvant radiotherapy. Results Local recurrence was diagnosed in 54 (35%) patients. Radiation therapy reduced the rate of local recurrences, although with no statistical significance. The time between surgery and initiation of postoperative radiotherapy did not significantly influence the risk of local recurrence in patients referred to adjuvant treatment (p=0.49). Conclusion In the presence of risk factors for local recurrence, a short delay in starting the adjuvant radiation therapy does not contraindicate its performance.
- How to Avoid Injury of the External Branch of Superior Laryngeal Nerve(2012) CERNEA, Claudio R.; DEDIVITIS, Rogerio A.; FERRAZ, Alberto R.; BRANDAO, Lenine G.
- Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth(2013) AMAR, Ali; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. Objective: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. Method: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. Results: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. Conclusion: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease.
article 4 Citação(ões) na Scopus The surgical management of parotid gland tumours(2015) CASTRO, M. A. F.; DEDIVITIS, R. A.; GUIMARAES, A. V.; CERNEA, C. R.; BRANDAO, L. G.Background: The parotid tissue can give rise to a large variety of benign and malignant neoplasms. The objective of this study was to describe the management and outcome of parotid gland tumours over a 15-year period. Method: The records of consecutive patients treated by parotid gland excision from January 1995 to December 2008 were reviewed retrospectively. Data recorded were age, gender, history, physical findings, surgical procedure, fine-needle aspiration biopsy (FNAB), final pathological diagnosis and complications. Results: The vast majority of patients (306) had benign neoplasms, and 14 patients had malignant neoplasms. Overall, pleomorphic adenoma contributed to 76% of the lesions, and Warthin's tumour to 17%. The sensitivity and specificity of FNAB was 79% and 100%, respectively. There were 15 cases of marginal mandibular transitory paresis and 12 cases of seroma. Marginal mandibular definitive paralysis was observed in three cases with malignant tumour. Conclusion: Standardised parotidectomy is a safe operation, with a low complication rate.- 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 8 Citação(ões) na Scopus Cervical metastasis on level IV in laryngeal cancer(2014) ARAUJO NETO, V. J. Furtado De; CERNEA, C. R.; DEDIVITIS, R. Aparecido; PALAZZO, J. Fabiano; BRANDAO, L. GarciaThe presence of cervical metastasis has substantial negative impact on survival of patients with laryngeal cancer. Bilateral elective selective neck dissection of levels II, II and IV is usually the chosen approach in these patients. However, there is significant morbidity associated with level IV dissection, such as phrenic nerve injury and lymphatic fistula. The objective of the present study was to evaluate the frequency of metastatic nodes in level IV in clinically T3/T4N0 patients with laryngeal cancer. The pathological reports of 77 patients with clinically T3/T4N0 laryngeal squamous cell carcinoma were reviewed. Patients underwent bilateral lateral neck dissection from January 2007 to November 2012. The surgical specimens were subdivided in levels before evaluation. There were 12 patients with neck metastasis (15.58%). In 3 cases (3.89%), there were metastatic lymph nodes in level IV, all T4 and with ipsilateral metastasis. In conclusion, the incidence of level IV metastasis was 3.89%, an in all patients was staged as T4.- Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review(2014) AIRES, Felipe T.; DEDIVITIS, Rogerio A.; CASTRO, Mario Augusto F.; BERNARDO, Wanderley Marques; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaBackground Some primary studies compare manual and mechanical pharyngeal closures after total laryngectomy. The purpose of this study was to evaluate the advantages of the mechanical suture in pharyngeal closure. Methods The literature survey included research in MEDLINE, EMBASE, and LILACS. The intervention analyzed was stapler-assisted pharyngeal closure, whereas the control group was manual suture pharyngeal closure. Results The survey resulted in 319 studies. However, 4 studies were selected (417 patients). In the group of patients in whom the stapler was used, the incidence of pharyngocutaneous fistula was 8.7%, whereas in the other, it was 22.9%, with an absolute risk reduction of 15% (95% confidence interval [CI], 0.02-0.28; p = .02; I-2 = 66%). Regarding the surgical time, the average difference was 80 minutes in favor of the stapler group (95% CI, 23.16-136.58 minutes; p < .006). Conclusion The difference for starting oral feeding was 8 days in favor of the mechanical suture (95% CI, 4.01-11.73 days; p < .001). Patients who underwent mechanical suture had a shorter hospitalization period. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 739-742, 2014
- Epidemiological assessment and therapeutic response in hypopharyngeal cancer(2013) AMAR, Ali; CURIONI, Otavio Alberto; PAIVA, Diogenes Lopes de; RAPOPORT, Abrao; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaDespite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. Objective: To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. Method: We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. Results: The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. Conclusion: Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
- Value of immunohistochemistry in the diagnosis of malignant cervical lymph nodes(2013) CALY, Decio de Natale; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe cervical lymph nodes are relevant due to the diversity of clinical entities. The use of immunohistochemistry is a real method to elucidate the diagnosis of adenopathy, both primary and metastatic neoplasms. Objective: To assess the value of immunohistochemistry in the diagnosis of cervical lymph nodes malignancies. Method: Retrospective study of the database histopathological specimens from 2009 to 2011. Results: Out of 32 biopsies of cervical lymph nodes, in 16 (50%) the immunohistochemistry was employed, being 68.75% (11) in hematological neoplasms and 31.25% (5) in carcinomas. It was used in all cases of lymphoma. Conclusion: The immunohistochemistry was used in 50% of the biopsies of lymph nodes under suspicion of malignancy, being 31.25% in epithelial lesions and 68.75% in lymphoproliferative lesions.
- Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review(2016) GUIMARAES, Andre Vicente; AIRES, Felipe Toyama; DEDIVITIS, Rogerio Aparecido; KULCSAR, Marco Aurelio Vamondes; RAMOS, Daniel Marin; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaBackground. The role of pectoralis major muscle flap (PMMF) in reducing the rate of pharyngocutaneous fistula after salvage total laryngectomy has not been clearly established. The purpose of this study was to evaluate the impact of PMMF in reducing pharyngocutaneous fistula rates after total laryngectomy. Methods. The analyzed intervention was the use of a PMMF after total laryngectomy. Results. Pharyngocutaneous fistula occurred in 230 cases (global incidence, 30.9%). In the group of patients who underwent PMMFs, there were 49 cases of pharyngocutaneous fistula, compared with 181 cases in the control group. There was a 22% decreased risk of pharyngocutaneous fistula incidence in the PMMF group (p < .001). Patients who underwent a PMMF had lower risk of pharyngocutaneous fistula compared with the control group (p = .008). There were no changes when only patients who underwent total laryngectomy (p < .001) and those who underwent total pharyngolaryngectomy (p = .007) were separately assessed. Conclusion. Prophylactic use of PMMF decreases the incidence of pharyngocutaneous fistula after salvage total laryngectomy. (C) 2015 Wiley Periodicals, Inc.