FABIO CESAR MIRANDA TORRICELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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- One week pre-operative oral antibiotics for percutaneous nephrolithotomy reduce risk of infection: a systematic review and meta-analysis(2023) DANILOVIC, Alexandre; TALIZIN, Thalita Bento; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni S.; BATAGELLO, Carlos; VICENTINI, Fabio C.; NAHAS, Willaim C.; MAZZUCCHI, EduardoPurpose: The aim of this meta-analysis is to assess the efficacy of extended dose of preoperative antibiotics to reduce infectious risk in patients undergoing percutaneous nephrolithotomy (PCNL).Materials and Methods: A literature search for prospective case-control studies or randomized controlled trials was done. PICO framework was used.Population: adult patients that underwent to PCNL; Intervention: extended dose preoperative antibiotic prophylaxis before PCNL; Control: short dose preoperative antibiotic prophylaxis befo-re PCNL; and Outcome: systemic inflammatory response syndrome (SIRS) or sepsis, fe-ver after PCNL and positive intraoperative urine and stone culture. This meta-analysis was registered in PROSPERO database under the number: CRD42022359589.Results: Three RCT and two prospective studies (475 patients) were included. SIRS/ sepsis outcome was retrieved from all studies included. Seven days preoperative oral antibiotics for PCNL was a protective factor for developing SIRS/sepsis (OR 0.366, 95% CI 0.234 -0.527, p < 0.001). There was no statistical association between seven-day use of antibiotics and fever (OR 0.592, 95% CI 0.147 - 2.388, p = 0.462). Patients who received seven days preoperative antibiotics had lower positive intraoperative urine culture (OR 0.284, 95% CI 0.120 - 0.674, p = 0.004) and stone culture (OR 0.351, 95% CI 0.185 - 0.663, p = 0.001) than the control group.Conclusion: one week of prophylactic oral antibiotics based on local bacterial sensi-tivity pattern plus a dose of intravenous antibiotics at the time of surgery in patients undergoing PCNL reduces the risk of infection.
- Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes (vol 33, pg 527, 2019)(2023) DANILOVIC, Alexandre; NUNES, E.; LIPKIN, M. E.; FERREIRA, T.; TORRICELLI, F. C. M.; MARCHINI, G. S.; SROUGI, M.; NAHAS, W. C.; MAZZUCCHI, E.
conferenceObject POSTOPERATIVE ANTIBIOTIC PROPHYLAXIS FOR PERCUTANEOUS NEPHROLITHOTOMY AND RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) TALIZIN, Thalita; DANILOVIC, Alexandre; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; NAHAS, William; MAZZUCCHI, EduardoconferenceObject ONE WEEK PREOPERATIVE ORAL ANTIBIOTICS FOR PERCUTANEOUS NEPHROLITHOTOMY REDUCE RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) DANILOVIC, Alexandre; TALIZIN, Thalita; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; NAHAS, William; MAZZUCCHI, Eduardo- Nomogram to predict uric acid kidney stones based on patient's age, BMI and 24-hour urine profiles: A multicentre validation(2015) TORRICELLI, Fabio Cesar Miranda; BROWN, Robert; BERTO, Fernanda C. G.; TARPLIN, Sarah; SROUGI, Miguel; MAZZUCCHI, Eduardo; MONGA, ManojIntroduction: We performed a multicentre validation of a nomogram to predict uric acid kidney stones in two populations. Methods: We reviewed the kidney stone database of two institutions, searching for patients with kidney stones who had stone composition analysis and 24-hour urine collection from January 2010 to December 2013. A nomogram to predict uric acid kidneys stones based on patient age, body mass index (BMI), and 24-hour urine collection was tested. Receiver-operating curves (ROC) were performed. Results: We identified 445 patients, 355 from Cleveland, United States, and 90 from Sao Paulo, Brazil. Uric acid stone formers were 7.9% and 8.9%, respectively. Uric acid patients had a significantly higher age and BMI, as well as significant lower urinary calcium than calcium stone formers in both populations. Uric acid had significantly higher total points when scored according to the nomogram. ROC curves showed an area under the curve of 0.8 for Cleveland and 0.92 for Sao Paulo. The cutoff value that provided the highest sensitivity and specificity was 179 points and 192 for Cleveland and Sao Paulo, respectively. Using 180 points as a cutoff provided a sensitivity and specificity of 87.5% and 68% for Cleveland, and 100% and 42% for Sao Paulo. Higher cutoffs were associated with higher specificity. The main limitation of this study is that only patients from high volume hospitals with uric acid or calcium stones were included. Conclusion: Predicting uric acid kidneys stone based on a nomogram, which includes only demographic data and 24-hour urine parameters, is feasible with a high degree of accuracy.
- Reply by Authors(2022) PERRELLA, R.; VICENTINI, F. C.; PARO, E. D.; TORRICELLI, F. C. M.; MARCHINI, G. S.; DANILOVIC, A.; BATAGELLO, C. A.; MOTA, P. K. V.; FERREIRA, D. B.; COHEN, D. J.; MURTA, C. B.; CLARO, J. F. A.; GIUSTI, G.; MONGA, M.; NAHAS, W. C.; SROUGI, M.; MAZZUCCHI, E.
- Urologic issues in pediatric transplant recipients(2019) TORRICELLI, Fabio C. M.; WATANABE, Andrea; PIOVESAN, Affonso C.; DAVID-NETO, Elias; NAHAS, William C.The limited supply of kidneys for pediatric transplantation leads to a large number of children in waiting transplant list. These patients have to be properly evaluated and prepared before organ transplantation to increase its success. The aim of this review is focus on urologic issues of pediatric kidney transplants such as preoperative evaluation and urinary tract abnormalities correction, surgical technique, and postoperative complications. All children that are candidates for kidney transplantation should be submitted to abdominal ultrasound. If bladder dysfunction is suspected, a more detailed evaluation is mandatory, including a voiding cystourethrography and urodynamic study. Patients with a poor bladder capacity and compliance will require bladder augmentation. Whenever possible the native ureter is recommended for that. Regarding kidney transplantation, recipient surgery can be safely performed through an extraperitoneal access, even in children weighting less than 10 kilograms. It allows adequate access to iliac vessels, aorta and vena cava. Graft survival continued to improve over the past decade and it is around 80% in 5 years. Postoperative complications such as urinary fistula may occur in less than 5% of cases, while vascular complications are reported in 1% to 2% of cases.
- Laparoendoscopic single site surgery versus conventional laparoscopy for transperitoneal pyeloplasty: A systematic review and meta-analysis(2015) BRANDAO, Luis Felipe; LAYDNER, Humberto; ZARGAR, Homayoun; TORRICELLI, Fabio; ANDREONI, Cassio; KAOUK, Jihad; AUTORINO, RiccardoWe aimed to review studies comparing the outcomes of the laparoendoscopic single site (LESS) pyeloplasty with those of conventional laparoscopic pyeloplasty (CLP). A systematic review of the literature was performed according to the PRISMA (preferred reporting items for systematic reviews and meta-analysis) criteria. The methodological quality of the studies was rated according validated scales. The level of evidence (LE) was reported as described by the Oxford criteria. Preoperative demographic parameters and perioperative outcomes between the two surgical techniques were assessed. A meta-analysis of the included studies was performed. A total of 5 studies were elected for the analysis, including 164 cases, 70 (42.6%) of them being LESS and 94 (57.4%) being CLP. Four studies were observational retrospective comparative studies (LE: 3a-4); one was a prospective randomized controlled trial (LE: 2b). There was no significant difference in age, body mass index, gender, side and presence of the crossing vessel, between the groups. There was no significant difference regarding the operative time (weight mean difference [WMD]: 7.02; 95% confidence interval [CI]: 71.82-57.79; P = 0.83) and length of hospital stay (WMD: 0.04; 95% CI: 0.11-0.20; P = 0.58), whereas the estimated blood loss was statistically lower for LESS (WMD: 16.83; 95% CI: 31.79-1.87; P = 0.03). The postoperative use of analgesic favored the LESS group but without reaching statistical significance (WMD: 7.52; 95% CI: 17.56-2.53; P = 0.14). In conclusion, LESS pyeloplasty offers comparable surgical and functional outcomes to CLP while providing the potential advantages of less blood loss and lower analgesic requirement. Thus, despite being more technically challenging, LESS pyeloplasty can be regarded as a minimally invasive approach for patients seeking fewer incisional scars.
- Nocturia is the Lower Urinary Tract Symptom With Greatest Impact on Quality of Life of Men From a Community Setting(2014) MIRANDA, Eduardo de Paula; GOMES, Cristiano Mendes; TORRICELLI, Fabio Cesar Miranda; BESSA JUNIOR, Jose de; CASTRO, Jose Everton de; FERREIRA, Bruno Roberto da Silva; SCAFURI, Ariel Gustavo; BRUSCHINI, Homero; SROUGI, MiguelPurpose: Lower urinary tract symptoms are numerous, but the specific impact of each of these symptoms on the quality of life (QoL) has not been evaluated in community-dwelling men. An assessment of these symptoms and their effects on QoL was the focus of this study. Methods: We performed a cross-sectional study with 373 men aged > 50 years from a community setting. Patients completed the International Prostate Symptom Score questionnaire, which includes questions on each of the specific urinary symptoms and a question addressing health-related QoL that are graded from 0 to 5. We used the Pearson correlation test to assess the impact of each symptom on QoL. Results: Nocturia (58.9%) was the most prevalent urinary symptom. The mean score was 0.9 +/- 1.4 for incomplete emptying, 1.0 +/- 1.5 for frequency, 0.9 +/- 1.3 for intermittency, 0.8 +/- 1.3 for urgency, 1.0 +/- 1.5 for weak stream, 0.5 +/- 1.0 for straining, and 2.0 +/- 1.6 for nocturia. Nocturia and frequency were the only symptoms associated with poorer QoL, with nocturia showing a stronger association. Conclusions: Nocturia affects 50% of community dwelling men aged > 50 years, and is the lower urinary tract symptom with the greatest negative impact on QoL.
- Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique(2015) MARCHINI, Giovanni Scala; TORRICELLI, Fabio Cesar Miranda; MAZZUCCHI, Eduardo; SROUGI, Miguel; MONGA, ManojThe management of encrusted ureteral stents is costly, time consuming and may be risky for the patient and challenging for the urologist. Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy, cystolithopaxy, rigid or flexible ureteroscopy with intracorporeal lithotripsy, percutaneous nephrolithotomy, open surgery, and a combination of those methods. In this study we describe the management of severe forgotten encrusted ureteral stents in 3 female patients using a prone split-leg position. This position allows us to effectively treat any site and degree of stent encrustation in a single-session approach with the patient in the same position during the whole procedure. All patients were rendered stent and stone free. No complications occurred.