EDUARDO HIROSHI AKAISHI
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
17 resultados
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Agora exibindo 1 - 10 de 17
- Acute appendicitis, inflammatory appendiceal mass and the risk of a hidden malignant tumor: a systematic review of the literature(2017) TEIXEIRA JR., Frederico Jose Ribeiro; COUTO NETTO, Sergio Dias do; AKAISHI, Eduardo Hiroshi; UTIYAMA, Edivaldo Massazo; MENEGOZZO, Carlos Augusto Metidieri; ROCHA, Marcelo CristianoIntroduction: Acute appendicitis is significantly common. Despite the increased use of computed tomography, the number of perforated cases has been stable in the past three decades. Between 2% and 6% of patients with acute appendicitis present appendiceal mass, often described as inflammatory phlegmon or abscess. Malignant tumors are confirmed by pathological analysis in 0.9-1.4% of all appendectomies performed to treat acute appendicitis. However, recent series demonstrate an elevated incidence of malignancies, ranging from 5.9 to 12%, in patients with inflammatory appendiceal mass. Methods: The analysis was based on a systematic review of the literature. The articles were searched in PubMed for the period from 1987 to 2016. Articles presenting the incidence of the hidden malignancy among patients with appendiceal inflammatory mass were selected. Variables as age, interval appendectomy rate, the incidence of neoplasm, time to surgery, minimally invasive assessment, histology, right colectomy rate and morbidity were analyzed. Results: A total of 13.244 patients were described as presenting acute appendicitis. Appendiceal tumor is present in approximately 1% of the appendectomies, while the rate of neoplasm varies from 10 to 29% in patients presenting appendiceal inflammatory mass. Interval appendectomies, despite been the minority of the procedures, disregard the higher morbidity associated with right sided colectomies. The review of literature also describes oncologic, histologic and clinical aspects of patients presenting appendiceal neoplasm, describing the most frequent histologic subtypes of this illness. Conclusion: Hidden appendiceal neoplasm in acute appendicitis are rare, fortunately. However, its incidence is much higher in patients presenting appendiceal inflammatory mass. Hence, interval appendectomy should be considered in this subgroup of patients.
- Multivisceral resection for retroperitoneal liposarcoma-is it worth it? A 20-year single-center experience(2023) JR, Frederico Ribeiro Teixeira; ARAKAKI, Mariana Sousa; LIMA, Helber Vidal Gadelha; FERREIRA, Fabio de Oliveira; MENEGOZZO, Carlos Augusto Metidieri; SILVA, Eduardo Rissi; MONTERO, Edna Frasson de Souza; OYA, Toshiko; LIMA, Luiz Calima; AKAISHI, Eduardo Hiroshi; UTIYAMA, Edivaldo MassazoPurposeSoft tissue sarcomas are rare malignant tumors. Liposarcoma constitutes the most frequent histological subtype of retroperitoneal sarcoma. The prognosis of soft tissue sarcomas depends on clinical and histologic characteristics.ObjectiveEvaluate variables that may be related to the overall and local recurrence-free survival in patients with retroperitoneal liposarcoma and discuss the need for visceral resection en-bloc for tumors.MethodsA retrospective analysis was conducted of the medical records of 60 patients seen between 1997 and 2017 who underwent surgical resection of retroperitoneal liposarcoma.ResultsThe overall survival rate at 5 years of follow-up was 75.22% (95% confidence interval [CI] 0.58-0.86). The probability of a local recurrence-free survival at 5 years of follow-up was 26.04% (95% CI 0.11-0.44). The multivariate analysis showed that dedifferentiated or pleomorphic tumors and R2/fragmented resection were associated with a shorter time to recurrence. No other characteristics markedly influenced the overall survival (P > 0.05).ConclusionPatients with dedifferentiated or pleomorphic tumors and incomplete resection were associated with higher local recurrence rates than others. This study reinforces the need for complete and en-bloc resection with organs when there is clear involvement or technical surgical difficulty to maintain the tumor integrity.
- Can we respect the principles of oncologic resection in an emergency surgery to treat colon cancer?(2015) TEIXEIRA, Frederico; AKAISHI, Eduardo Hiroshi; USHINOHAMA, Adriano Zuardi; DUTRA, Tiago Cypriano; COUTO NETTO, Sergio Dias do; UTIYAMA, Edivaldo Massazo; BERNINI, Celso Oliveira; RASSLAN, SamirPatients with colorectal cancer admitted to the emergency room are generally at more advanced stage of the disease and are usually submitted to a resection with curative intent in a smaller scale. In such scenario, one of the aspects to be considered is whether the principles of oncologic resection are observed when those patients diagnosed with colon cancer are treated with surgery. We selected 87 patients with adenocarcinoma of colon and/or upper rectum submitted to an emergency surgical resection. The major variables reviewed retrospectively were: the extent of resection performed, the number of dissected regional lymph nodes and the overall survival rate. Intestinal obstruction was observed in 67 patients (77%) while perforation was found in 20 patients (23%). Seven (8%) specimens had circumferential compromised margins, all found in patients with T4 tumors combine with poor clinical status. The number of dissected regional lymph nodes was greater than, or equal to, 12 in 71% of patients. While the average days of stay in the ICU was 5.7 days, the median was 3 days. The morbidity and peri-operative mortality stood at 33.6% and 20%, respectively. The outcome of an emergency surgery of colorectal cancer observed in this study was similar to those found in the literature. The principles of oncologic resection were respected when considering and analyzing the extent of the resection, the surgical margins and the number of dissected lymph nodes.
- Current practice of Latin American centers in the treatment of peritoneal diseases with cytoreductive surgery with HIPEC(2018) QUADROS, C. A.; LAPORTE, G. A.; HUGUENIN, J. F. L.; BARRETO, E. J. S. S.; V, A. Barros; OLIVEIRA, A. F.; CARVALHO, A. L. L.; PETRUZZIELLO, A.; PAULA, A. C.; URBANO-RUIZ, A.; SANTOS, C. C.; GALHARDO, C. A. V. G.; JOHNSON, L. F. P.; VENDRAME, C. D.; SANTANA, D. P.; AKAISHI, E.; FERREIRA, F. O.; QUEIROZ, F. L.; MIRANDA, F. A. C. L.; LISSA, F. C. T.; SARMENTO, B. J. Q.; NASCIMENTO, G. J. S.; NOVASKI, G. L.; MEINHARDT, J. G. J.; MALI-JUNIOR, J.; V, J. Barreto-Junior; SALOMAO-JUNIOR, L. R.; V, C. Pinto; CAVALLA, C.; SANCHEZ-LORIA, F. A.; COELHO-JUNIOR, M. J. P.; PERROTTA, F. M.; FLORES-AYALA, E. G.; MARTINEZ-SAID, H.; DE-LA-FUENTE, H.; LOPEZ-BASAVE, H. N.; SANDOVAL-JAUREGUI, J.; BUTTE, J. M.; FLOREZ, J. P.; RUSO, M. L.; BELOTTO, M.; MATUS, R. R. G.; SOUZA-FILHO, O.; CAMARA, P. C.; SEITENFUS, R.; ANSELMI-JUNIOR, R. A.; CUTAIT, R.; V, R. M. L. Leal; BOFF, M. F.; SABBAG, R.; SILVA, R. G.; MORAN, A. R.; SALCEDO-HERNANDEZ, R. A.; AGUIAR-JUNIOR, S.; RAMIREZ, S. R.; REIS, T. J. C. C.; BATISTA, T. P.; FRANCISCHETTO, T.; GAVA, V. G.; ARIAS, F.; CASTRO, J. M. M.; PACHECO, M.; GARCIA, M. M.; VENANCIO, C.; LEONARDI, P. C.; ZANATTO, R. M.; WAINSTEIN, A. J. A.; CORDEIRO, E. Z.; PERINA, A. L. F.; FIGUEIREDO, P. H. M.; PEREIRA, L. F.; MOLINA, M. E.; VAZQUEZ, V. L.; TEIXEIRA-JUNIOR, F. J. R.Introduction: A combination therapy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been proposed as a treatment option in patients with peritoneal metastasis of colorectal, ovarian, gastric cancers and sarcomas and as a current standard treatment for pseudomyxoma peritonei and peritoneal mesothelioma. There is a need to standardize its indication, drugs selection along with their concentrations and ways to deliver peritoneal chemotherapy solutions for best outcomes. Aim of the study: To investigate the current practice of Latin American (LA) Centers in which peritoneal diseases (PD) are treated. Patient and Methods: All centers from Latin American Registry of Peritoneal Diseases (LARPD) were invited to participate in a two rounds online survey, to describe their current practice in all indications of CRS with HIPEC for PD. Results: 76 out of 84 LARPD's centers answered the survey, with a response rate of 90,5%. The results represent the current practice of 248 surgeons that are members of LARPD's centers, in 8 LA countries, that at the time of the study had treated 2682 patients with CRS with HIPEC. All current practice aspects including indications, contra-indications, patient selection, methods of peritoneal chemotherapy delivery and treatment protocols are described in this manuscript. Conclusions: This survey is the first LA effort to publish current practice indications and treatment protocols of PD. Achieving consensus of best therapeutic options is essential to provide the best possible outcomes for patients with PD who could benefit from CRS with HIPEC therefore aiming at standardization of the procedure.
- Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): The First Reported Case in Brazil Using Standardized Technique with the Capnopen (R) Nebulizer Device(2021) AKAISHI, Eduardo Hiroshi; SILVA, Diego Greatti Vaz da; LIMA, Helber Vidal Gadelha; GRAPPERON-MATHIS, Roberta Lages M.; ARAKAKI, Mariana de Souza; GALINDO, Ivan Vinicius Andrade; DAIA, Lucas Afonso; ARARUNA, Gustavo Ferreira; OLIVEIRA, Andre Luiz Torres; MANCINI, Caio Nasser; HOFF, Paulo Marcelo GehmObjective: setting Background: Peritoneal metastasis is a common progression of abdominal-pelvic cancers, and it is associated with poorer oncological prognosis when compared to other metastasis sites. Its treatment has limited results, mainly because of poor bioavailability of chemotherapy within the abdominal cavity after systemic administration. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been proposed as a novel method to deliver chemotherapy directly into the peritoneal surface; it combines the effectiveness and response of an intraperitoneal therapy with benefits of a minimally invasive approach. The laparoscopic capnoperitoneum is used to instill chemotherapy particles in a more efficient way for distribution and penetration when compared to peritoneal lavage. In the present study, we describe the first PIPAC performed in Brazil, according to the standard technique previously described with the Capnopen (R) nebulizer device, as well as technique details based on our literature review. Case Report: A 67-year-old man with pancreatic adenocarcinoma metastatic to the liver at first diagnosis underwent systemic treatment with the FOLFIRINOX protocol. After a major clinical response due to systemic treatment, pancreaticoduodenectomy was performed with resection and radiofrequency ablation of hepatic nodules. After 7 months of follow-up, the patient's condition evolved with symptomatic relapse in the peritoneum. Aiming at better control of this site, multiple PIPAC procedures were performed, showing excellent control of the peritoneal cavity disease. The patient had a sustained response in the peritoneal cavity and showed systemic disease progression 6 months after the first PIPAC procedure, which deceased at 20 months after the first PIPAC procedure and 42 months after the primary diagnosis. Conclusions: This report shows that the PIPAC procedure is reproducible elsewhere, with safety and good functional results.
- A proposal of Brazilian Society of Surgical Oncology for standardizing cytoreductive surgery plus hypertermic intraperitoneal chemotherapy procedures in Brazil: pseudomixoma peritonei, appendiceal tumors and malignant peritoneal mesothelioma(2017) BATISTA, Thales Paulo; SARMENTO, Bruno José Queiroz; LOUREIRO, Janina Ferreira; PETRUZZIELLO, Andrea; LOPES, Ademar; SANTOS, Cassio Cortez; QUADROS, Cláudio de Almeida; AKAISHI, Eduardo Hiroshi; CORDEIRO, Eduardo Zanella; COIMBRA, Felipe José Fernández; LAPORTE, Gustavo Andreazza; CASTRO, Leonaldson Santos; BATISTA, Ranyell Matheus Spencer Sobreira; AGUIAR JÚNIOR, Samuel; COSTA JÚNIOR, Wilson Luiz; FERREIRA, Fábio OliveiraABSTRACT Cytoreductive surgery plus hypertermic intraperitoneal chemotherapy has emerged as a major comprehensive treatment of peritoneal malignancies and is currently the standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome as well as malignant peritoneal mesothelioma. Unfortunately, there are some worldwide variations of the cytoreductive surgery and hypertermic intraperitoneal chemotherapy techniques since no single technique has so far demonstrated its superiority over the others. Therefore, standardization of practices might enhance better comparisons between outcomes. In these settings, the Brazilian Society of Surgical Oncology considered it important to present a proposal for standardizing cytoreductive surgery plus hypertermic intraperitoneal chemotherapy procedures in Brazil, with a special focus on producing homogeneous data for the developing Brazilian register for peritoneal surface malignancies.
- Abdominal wall reconstruction after desmoid type fibromatosis radical resection: Case series from a single institution and review of the literature(2017) NETO, S. D. Couto; TEIXEIRA JR., F.; MENEGOZZO, C. A. M.; ALBERTINI, A.; AKAISHI, E. H.; UTIYAMA, E. M.BACKGROUND: Abdominal wall desmoid type fibromatosis management has been changing over recent years, from an aggressive approach towards a more conservative one. When radical resection is indicated, the surgical team faces the challenge of abdominal wall reconstruction, for which optimal technique is still debated. The present study reports the experience from a single center with abdominal closures after desmoid type fibromatosis resection. MATERIAL AND METHODS: Retrospective analysis of patients who underwent abdominal wall closure after sporadic abdominal desmoid type fibromatosis radical resection from 1982 to 2013. RESULTS: Twenty-seven patients were included, mean tumor diameter was 10 + 5.3 cm, and the main choice of abdominal wall reconstruction was midline closure with anterior rectus sheath relaxing incisions and polypropylene onlay mesh (74% of the cases). Only 7% of the cases required more complex procedures for skin closure. Mean follow-up was 5 years and 89% remained disease-free. No grade 4 or 5 complications were observed. CONCLUSION: High midline fascial closure rate can be achieved after resection of abdominal wall desmoid tumor using relaxing incisions and mesh, with low complication rate. (C) 2017 The Author(s).
- Popliteal lymph node dissection for metastases of cutaneous malignant melanoma(2014) TEIXEIRA, Frederico; MOUTINHO JR., Vitor; AKAISHI, Eduardo; MENDES, Gabriella; PERINA, Andre; LIMA, Tiberio; LALLEE, Margareth; COUTO, Sergio; UTIYAMA, Edivaldo; RASSLAN, SamirPopliteal lymph node dissection is performed when grossly metastatic nodal disease is encountered in the popliteal fossa or after microscopic metastasis is found in interval sentinel nodes during clinical staging of cutaneous malignant melanoma. Initially, an S-shaped incision is made to gain access to the popliteal fossa. A careful en bloc removal of fat tissue and lymph nodes is made to preserve and avoid the injury of peroneal and tibial nerves as well as popliteal vessels, following the previous recommendations. This rare surgical procedure was successfully employed in a patient with cutaneous malignant melanoma and nodal metastases at the popliteal fossa. The technique described by Karakousis was reproduced in a step-by-step fashion to allow anatomical identification of the neurovascular structures and radical resection with no post-operative morbidity and prompt recovery. Popliteal lymph node dissection is a rarely performed operative procedure. Following a lymphoscintigraphic examination of the popliteal nodal station, surgeons can be asked to explore the popliteal fossa. Detailed familiarity of the operative procedure is necessary, however, to avoid complications.
- Brazilian Group of Gastrointestinal Tumours' consensus guidelines for the management of gastric cancer(2020) PEIXOTO, Renata D'Alpino; ROCHA-FILHO, Duilio R.; WESCHENFELDER, Rui F.; REGO, Juliana F. M.; RIECHELMANN, Rachel; COUTINHO, Anelisa K.; FERNANDES, Gustavo S.; JACOME, Alexandre A.; ANDRADE, Aline C.; MURAD, Andre M.; MELLO, Celso A. L.; MIGUEL, Diego S. C. G.; GOMES, Diogo B. D.; RACY, Douglas J.; MORAES, Eduardo D.; AKAISHI, Eduardo H.; CARVALHO, Elisangela S.; MELLO, Evandro S.; MALUF FILHO, Fauze; COIMBRA, Felipe J. F.; CAPARELI, Fernanda C.; ARRUDA, Fernando F.; VIEIRA, Fernando M. A. C.; TAKEDA, Flavio R.; COTTI, Guilherme C. C.; PEREIRA, Guilherme L. S.; PAULO, Gustavo A.; RIBEIRO, Heber S. C.; LOURENCO, Laercio G.; CROSARA, Marcela; TONETO, Marcelo G.; OLIVEIRA, Marcos B.; OLIVEIRA, Maria de Lourdes; BEGNAMI, Maria Dirlei; FORONES, Nora M.; YAGI, Osmar; ASHTON-PROLLA, Patricia; AGUILLAR, Patricia B.; AMARAL, Paulo C. G.; HOFF, Paulo M.; ARAUJO, Raphael L. C.; PAULA FILHO, Raphael P. Di; GANSL, Rene C.; GIL, Roberto A.; PFIFFER, Tulio E. F.; SOUZA, Tulio; JR, Ulysses Ribeiro; JESUS, Victor Hugo F.; JR, Wilson L. Costa; PROLLA, GabrielGastric cancer is among the ten most common types of cancer worldwide. Most cases and deaths related to the disease occur in developing countries. Local socio-economic, epidemiologic and healthcare particularities led us to create a Brazilian guideline for the management of gastric carcinomas. The Brazilian Group of Gastrointestinal Tumors (GTG) invited 50 physicians with different backgrounds, including radiology, pathology, endoscopy, nuclear medicine, genetics, oncological surgery, radiotherapy and clinical oncology, to collaborate. This document was prepared based on an extensive review of topics related to heredity, diagnosis, staging, pathology, endoscopy, surgery, radiation, systemic therapy and follow-up, which was followed by presentation, discussion, and voting by the panel members. It provides updated evidence-based recommendations to guide clinical management of gastric carcinomas in several scenarios and clinical settings.
- Brazilian Group of Gastrointestinal Tumours' consensus guidelines for the management of oesophageal cancer(2021) ROCHA-FILHO, Duilio R.; PEIXOTO, Renata D'Alpino; WESCHENFELDER, Rui F.; REGO, Juliana F. M.; RIECHELMANN, Rachel; COUTINHO, Anelisa K.; FERNANDES, Gustavo S.; JACOME, Alexandre A.; ANDRADE, Aline C.; MURAD, Andre M.; MELLO, Celso A. L.; MIGUEL, Diego S. C. G.; GOMES, Diogo B. D.; RACY, Douglas J.; MORAES, Eduardo D.; AKAISHI, Eduardo H.; CARVALHO, Elisangela S.; MELLO, Evandro S.; MALUF FILHO, Fauze; COIMBRA, Felipe J. F.; CAPARELI, Fernanda C.; ARRUDA, Fernando F.; VIEIRA, Fernando M. A. C.; TAKEDA, Flavio R.; COTTI, Guilherme C. C.; PEREIRA, Guilherme L. S.; PAULO, Gustavo A.; RIBEIRO, Heber S. C.; LOURENCO, Laercio G.; CROSARA, Marcela; TONETO, Marcelo G.; OLIVEIRA, Marcos B.; OLIVEIRA, Maria de Lourdes; BEGNAMI, Maria Dirlei; FORONES, Nora M.; YAGI, Osmar; ASHTON-PROLLA, Patricia; AGUILLAR, Patricia B.; AMARAL, Paulo C. G.; HOFF, Paulo M.; ARAUJO, Raphael L. C.; PAULA FILHO, Raphael P. Di; GANSL, Rene C.; GIL, Roberto A.; PFIFFER, Tulio E. F.; SOUZA, Tulio; JR, Ulysses Ribeiro; JESUS, Victor Hugo F.; JR, Wilson L. Costa; PROLLA, GabrielOesophageal cancer is among the ten most common types of cancer worldwide. More than 80% of the cases and deaths related to the disease occur in developing countries. Local socio-economic, epidemiologic and healthcare particularities led us to create a Brazilian guideline for the management of oesophageal and oesophagogastric junction (OGJ) carcinomas. The Brazilian Group of Gastrointestinal Tumours invited 50 physicians with different backgrounds, including radiology, pathology, endoscopy, nuclear medicine, genetics, oncological surgery, radiotherapy and clinical oncology, to collaborate. This document was prepared based on an extensive review of topics related to heredity, diagnosis, staging, pathology, endoscopy, surgery, radiation, systemic therapy (including checkpoint inhibitors) and follow-up, which was followed by presentation, discussion and voting by the panel members. It provides updated evidence-based recommendations to guide clinical management of oesophageal and OGJ carcinomas in several scenarios and clinical settings.