FABIO SHIGUEHISSA KAWAGUTI
Índice h a partir de 2011
12
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
66 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 66
- Diagnosis of Clinical Complete Response by Probe-Based Confocal Laser Endomicroscopy (pCLE) After Chemoradiation for Advanced Rectal Cancer(2021) SAFATLE-RIBEIRO, Adriana Vaz; MARQUES, Carlos Frederico Sparapan; PIRES, Clelma; ARRAES, Livia; BABA, Elisa Ryoka; MEIRELLES, Luciana; KAWAGUTI, Fabio Shigehissa; MARTINS, Bruno da Costa; LENZ, Luciano Tolentino; LIMA, Marcelo Simas de; GUSMON-OLIVEIRA, Carla Cristina; RIBEIRO JR., Ulysses; MALUF-FILHO, Fauze; NAHAS, Sergio CarlosBackground Neoadjuvant chemoradiotherapy (nCRxt) followed by radical surgery is the optimal treatment for advanced rectal adenocarcinoma. Patients with clinical complete response (cCR) may be followed closely without immediate surgery. Probe-based confocal laser endomicroscopy (pCLE) is a real-time in vivo method that allows acquisition of optical biopsies with 1000 times magnification, evaluating both epithelial and vascular patterns. Aim To evaluate the role of pCLE in the diagnosis of cCR after nCRxt for advanced rectal adenocarcinoma. Methods pCLE was performed in 47 patients with locally advanced rectal adenocarcinoma (T3/T4, or N+) who underwent nCRxt (5-fluorouracil, 5040 cGy). Results Twenty-seven (57.5%) patients were men, and the mean age was 62.8 years. Thirty-seven had partial response confirmed by pCLE. Ten (21.3%) patients had good endoscopic response and presented small ulcer (n = 5) or residual scar (n = 5). After nCRxt, the essential features to differentiate malignancy from post-radiation alterations at pCLE were the presence of irregular crypts, budding, back-to-back glands, cribriform pattern, increased vessel/crypt ratio, and fluorescein leakage. A scoring system was created considering these epithelial and vascular features, with high accuracy for differentiating patients with complete response from those with residual neoplasia (p < 0.00001). pCLE sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 100%, 71.4%, 95.2%, 100%, and 95.7%, respectively. Conclusions (1) pCLE evaluation of epithelial and vascular features may improve the diagnosis of cCR and may alter patient management; (2) pCLE might be valuable for identifying patients with advanced rectal cancer who will benefit from watch and wait strategy, avoiding immediate surgical treatment.
- LONG-TERM SURVIVAL ANALYSIS AFTER ENDOSCOPIC STENTING AS A BRIDGE TO SURGERY FOR MALIGNANT COLONIC OBSTRUCTION: COMPARISON WITH EMERGENCY SURGERY(2019) SCOMPARIN, Rodrigo Corsato; MARTINS, Bruno da Costa; MARQUES, Carlos F.; NAHAS, Caio Sergio R.; KAWAGUTI, Fabio S.; LENZ, Luciano; SAFATLE-RIBEIRO, Adriana V.; PAULO, Gustavo A. de; RIBEIRO, Ulysses; NAHAS, Sergio C.; MALUF-FILHO, Fauze
- PEG rescue with gastropexy after early tube withdrawal: an application of natural orifice transluminal endoscopic surgery (with video)(2011) MARTINS, Bruno da Costa; TAKADA, Jonas; KAWAGUTI, Fabio Shiguehissa; RIBEIRO, Joao Paulo Aguiar; HONDO, Fabio Yuji; LIMA, Marcelo Simas de; NEVES, Carla Zanellatto; NAHAS, Caio Sergio R.; MARQUES, Carlos Frederico Sparapan; SAKAI, Paulo; MALUF-FILHO, Fauze
conferenceObject PRELIMINARY RESULTS OF A RANDOMIZED CONTROLLED TRIAL COMPARING HEMOSTATIC POWDER VERSUS OPTIMAL CLINICAL TREATMENT IN THE MANAGEMENT OF GASTROINTESTINAL BLEEDING FROM MALIGNANCY(2018) MARTINS, Bruno da Costa; SCOMPARIN, Rodrigo Corsato; BENTO, Luiza H.; PIRES, Clelma Batista; PENNACCHI, Caterina; LENZ, Luciano; FRANCO, Matheus C.; KAWAGUTI, Fabio S.; SAFATLE-RIBEIRO, Adriana V.; RIBEIRO, Ulysses; MALUF-FILHO, FauzeconferenceObject Validation of Classic and Expanded Criteria for Endoscopic Submucosal Dissection of Early Gastric Cancer: 7 Years of Experience of a Western Tertiary Cancer Center(2017) MENDONCA, Ernesto Q.; OLIVEIRA, Joel F.; RIBEIRO, Maria Sylvia I.; SAFATLE-RIBEIRO, Adriana V.; MARTINS, Bruno da Costa; GUSMON, Carla C.; BABA, Elisa R.; PENNACCHI, Caterina; KAWAGUTI, Fabio S.; LENZ, Luciano; PAULO, Gustavo A. de; SORBELLO, Mauricio; UEMURA, Ricardo S.; GEIGER, Sebastian N.; LIMA, Marcelo S. de; RIBEIRO, Ulysses; MALUF-FILHO, Fauze- Magnifying chromoendoscopy is a reliable method in the selection of rectal neoplasms for local excision(2023) KIMURA, C. M. S.; KAWAGUTI, F. S.; HORVAT, N.; NAHAS, C. S. R.; MARQUES, C. F. S.; PINTO, R. A.; REZENDE, D. T. de; SEGATELLI, V.; SAFATLE-RIBEIRO, A. V.; JUNIOR, U. R.; MALUF-FILHO, F.; NAHAS, S. C.Purpose Adequate staging of early rectal neoplasms is essential for organ-preserving treatments, but magnetic resonance imaging (MRI) frequently overestimates the stage of those lesions. We aimed to compare the ability of magnifying chromoendoscopy and MRI to select patients with early rectal neoplasms for local excision. Methods This retrospective study in a tertiary Western cancer center included consecutive patients evaluated by magnifying chromoendoscopy and MRI who underwent en bloc resection of nonpedunculated sessile polyps larger than 20 mm, laterally spreading tumors (LSTs) >= 20 mm, or depressed-type lesions of any size (Paris 0-IIc). Sensitivity, specificity, accuracy, and positive and negative predictive values of magnifying chromoendoscopy and MRI to determine which lesions were amenable to local excision (i.e., <= T1sm1) were calculated. Results Specificity of magnifying chromoendoscopy was 97.3% (95% CI 92.2-99.4), and accuracy was 92.7% (95% CI 86.7-96.6) for predicting invasion deeper than T1sm1 (not amenable to local excision). MRI had lower specificity (60.5%, 95% CI 43.4-76.0) and lower accuracy (58.3%, 95% CI 43.2-72.4). Magnifying chromoendoscopy incorrectly predicted invasion depth in 10.7% of the cases in which the MRI was correct, while magnifying chromoendoscopy provided a correct diagnosis in 90% of the cases in which the MRI was incorrect (p = 0.001). Overstaging occurred in 33.3% of the cases in which magnifying chromoendoscopy was incorrect and 75% of the cases in which MRI was incorrect. Conclusion Magnifying chromoendoscopy is reliable for predicting invasion depth in early rectal neoplasms and selecting patients for local excision.
- Risk factors for adverse events of colorectal endoscopic submucosal dissection: a systematic review and meta-analysis(2021) SANTOS, Juliana B.; NOBRE, Moacyr R. C.; OLIVEIRA, Cleyton Z.; SAFATLE-RIBEIRO, Adriana V.; KAWAGUTI, Fabio; MARTINS, Bruno; NAHAS, Sergio C.; RIBEIRO JR., Ulysses; ZHANG, Lanjing; MALUF-FILHO, FauzeColorectal endoscopic submucosal dissection (ESD) is already an established treatment for superficial colorectal tumors. However, its technical difficulty and high adverse events rates, compared to endoscopic piecemeal mucosal resection, are a concern to some specialists and have probably contributed to discouragement in its widespread adoption. The debate mentioned above stimulated us to perform a systematic review aiming to identify risk factors for colorectal ESD-related adverse events. We conducted this study following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement and registered in the PROSPERO (University of York) international database (CRD42016042625). We searched MEDLINE, EMBASE, Cochrane Library and LILACS for the publications focused on risk factors for colorectal ESD-related adverse events from inception until April 2020. We included a total of 22 qualified studies in this analysis. We found that fibrosis had an odds ratio (OR) for perforation of 2.90 [95% confidence interval, (1.83-4.59)], right colon location of 2.35 (1.58-3.50), colonic location of 2.20 (1.44-3.35) and larger size of 2.17 (1.47-3.21), as well as one protective factor, the endoscopist experience OR = 0.62 (0.45-0.86). For bleeding, we considered rectal location a risk factor [OR = 3.55 (2.066.12)]. Through the several meta-analyses that we performed in this article, we could summarize the main risk factors for perforation and bleeding on colorectal ESD. Therefore, we provide insightful information for clinical judgment on regions where colorectal ESD is already widespread and help in the learning process of this challenging technique.
conferenceObject RANDOMIZED CONTROLLED TRIAL COMPARING UNDERWATER AND CONVENTIONAL ENDOSCOPIC MUCOSAL RESECTION FOR NON-PEDUNCULATED COLORECTAL LESIONS(2022) LENZ, Luciano H.; MARTINS, Bruno; PAULO, Gustavo A. De; KAWAGUTI, Fabio S.; BABA, Elisa R.; UEMURA, Ricardo S.; GUSMON, Carla C.; GEIGER, Sebastian N.; MOURA, Renata N.; PENNACCHI, Caterina; LIMA, Marcelo S. De; SAFATLE-RIBEIRO, Adriana V.; HASHIMOTO, Claudio L.; RIBEIRO, Ulysses; MALUF-FILHO, FauzeconferenceObject Probe-Based Confocal Endomicroscopy May Improve the Diagnosis of Clinical Complete Response After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Neoplasia(2018) SAFATLE-RIBEIRO, Adriana; MARQUES, Carlos; PIRES, Clelma; BABA, Elisa; MEIRELLES, Luciana; FARAJ, Sheila; ARRAES, Livia; ARAUJO, Diogo; GUSMON, Carla; KAWAGUTI, Fabio; LENZ, Luciano; SIMAS, Marcelo; MARTINS, Bruno; NAHAS, Caio; NAHAS, Sergio; RIBEIRO JR., Ulysses; MALUF FILHO, Fauze- Diagnostic accuracy of probe-based confocal laser endomicroscopy in Lugol-unstained esophageal superficial lesions of patients with head and neck cancer(2017) SAFATLE-RIBEIRO, Adriana Vaz; BABA, Elisa Ryoka; FARAJ, Sheila Friedrich; RIOS, Juliana Trazzi; LIMA, Marcelo Simas De; MARTINS, Bruno Costa; GEIGER, Sebastian Naschold; PENNACCHI, Caterina; GUSMAN, Carla; KAWAGUTI, Fabio Shiguehissa; UEMURA, Ricardo Sato; MELO, Evandro Sobroza de; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground and Aims: Surveillance programs of patients with head and neck cancer (HNC) detect synchronous or metachronous esophageal squamous cell carcinoma (ESCC) in up to 15% of patients. Noninvasive, probe-based confocal laser endomicroscopy (pCLE) technique may improve the diagnosis allowing acquisition of high-resolution in vivo images at the cellular and microvascular levels. The aim of this study was to evaluate the accuracy of pCLE for the differential diagnosis of nonneoplastic and neoplastic Lugol-unstained esophageal lesions in patients with HNC. Methods: Twenty-seven patients with HNC who exhibited Lugol-unstained esophageal lesions at surveillance endoscopy were prospectively included for pCLE. Diagnostic pCLE was followed by subsequent biopsies or endoscopic resection of suspected lesions. A senior pathologist was blinded to the pCLE results. Results: Patients mean age was 59 years (SD = 8.8) and 70.4% were men. All patients were smokers, and 22 patients (81.5%) had a history of alcohol consumption. The locations of HNC were oral cavity (n = 13), larynx (n = 10), and pharynx (n = 4). Thirty-seven lesions in 27 patients were studied. The final diagnoses were ESCC in 17 patients and benign lesions in 20 patients. Sensitivity, specificity, and accuracy of pCLE for the histologic diagnosis of ESCC in patients with HNC were 94.1%, 90.0%, and 91.9%, respectively. Conclusions: First, pCLE is highly accurate for real-time histology of Lugol-unstained esophageal lesions in patients with HNC. Second, pCLE may alter the management of patients under surveillance for ESCC, guiding biopsies and endoscopic resection, avoiding further diagnostic workup or therapy of benign lesions.