RICARDO SATO UEMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
39 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 39
- Endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of early rectal cancer(2014) KAWAGUTI, Fabio Shiguehissa; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; MARTINS, Bruno da Costa; RETES, Felipe Alves; MEDEIROS, Raphael Salles S.; HAYASHI, Takemasa; WADA, Yoshiki; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; NAHAS, Sergio Carlos; KUDO, Shin-ei; MALUF, FauzeEndoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) are minimally invasive procedures that can be used to treat early rectal cancer. The aim of this study was to compare clinical efficacy between ESD and TEM for the treatment of early rectal cancer. Between July 2008 and August 2011, 24 patients with early rectal cancers were treated by ESD (11) or TEM (13) at the Cancer Institute of So Paulo University Medical School (So Paulo, Brazil). Data were analyzed retrospectively according to database and pathological reports, with respect to en bloc resection rate, local recurrence, complications, histological diagnosis, procedure time and length of hospital stay. En bloc resection rates with free margins were achieved in 81.8 % of patients in the ESD group and 84.6 % of patients in the TEM group (p = 0.40). Mean tumor size was 64.6 +/- A 57.9 mm in the ESD group and 43.9 +/- A 30.7 mm in the TEM group (p = 0.13). Two patients in the TEM group and one patient in the ESD group had a local recurrence. The mean procedure time was 133 +/- A 94.8 min in the ESD group and 150 +/- A 66.3 min in the TEM group (p = 0.69). Mean hospital stay was 3.8 +/- A 3.3 days in the ESD group and 4.08 +/- A 1.7 days in the TEM group (p = 0.81). This was a non-randomized clinical trial with a small sample size and selection bias in treatment options. ESD and TEM are both safe and effective for the treatment of early rectal cancer.
- Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer(2018) GUSMON-OLIVEIRA, Carla Cristina; KUBOKI, Yeda Mayumi; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; MARTINS, Bruno Costa; TOLENTINO, Luciano Lenz; SAFATLE-RIBEIRO, Adriana Vaz; KULCSAR, Marco Aurelio; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground. Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis. Patients and methods. This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks. Results. From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial. Conclusion. The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.
- Balloon enteroscopy-assisted ERCP and cholangioscopy(2016) PAULO, Gustavo Andrade de; BASTOS, Victor Rossi; MARTINS, Bruno da Costa; SAFATLE-RIBEIRO, Adriana Vaz; GUSMON, Carla Cristina; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; MALUF FILHO, Fauze
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, 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.
conferenceObject 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, FauzeconferenceObject COMPARISON OF PLASTIC STENTS AND SELFEXPANDING METAL STENTS IN THE ENDOSCOPIC DRAINAGE OF MALIGNANT HILAR BILIARY OBSTRUCTION(2023) MENDIETA, Pastor Joaquin Ortiz; MARTINS, Bruno; CENTENO, Deborah; GREGORIO, Julia; SUETA, Rafael; SAFATLE-RIBEIRO, Adriana; PENNACCHI, Caterina; GUSMON, Carla; KAWAGUTI, Fabio; PAULO, Gustavo De; LENZ, Luciano; LIMA, Marcelo; UEMURA, Ricardo; NOBRE, Renata; GEIGER, Sebastian; MALUF, FauzeconferenceObject COMPARISON OF PLASTIC STENTS AND SELF-EXPANDING METAL STENTS IN THE ENDOSCOPIC DRAINAGE OF MALIGNANT HILAR BILIARY OBSTRUCTION(2023) MENDIETA, Pastor Joaquin Ortiz; MARTINS, Bruno; CENTENO, Deborah; GREGORIO, Julia; SUETA, Rafael; SAFATLE-RIBEIRO, Adriana; PENNACCHI, Caterina; GUSMON, Carla; KAWAGUTI, Fabio; PAULO, Gustavo De; LENZ, Luciano; LIMA, Marcelo; UEMURA, Ricardo; NOBRE, Renata; GEIGER, Sebastian; MALUF-FILHO, Fauzearticle Pancreatic Metastasis from Papillary Thyroid Carcinoma: A Case Report(2020) MACHADO, Andressa A.; LENZ, Luciano; DOMINGUES, Regina B.; LIMA, Gustavo R. A.; JOSINO, Iatagan R.; CORDERO, Martin A. C.; V, Adriana Safatle-Ribeiro; MARTINS, Bruno C.; PENNACCHI, Caterina M. P. S.; GUSMON, Carla C.; PAULO, Gustavo A.; LIMA, Marcelo S.; BABA, Elisa R.; KAWAGUTI, Fabio S.; UEMURA, Ricardo S.; MALUF-FILHO, FauzeIntroduction differentiated thyroid carcinoma presents with distant metastasis in 4% of cases, usually occurring in the lungs, bones and thoracic lymph nodes. Pancreatic involvement is extremely rare, with few cases reported in the literature. Case report A 47-years-old female patient presented abdominal pain. She had a history of papillary thyroid carcinoma surgically resected in 2009. After 10 years, computed tomography revealed hepatic lesions suggestive of secondary involvement and a solid mass in the pancreatic head. Endoscopic ultrasound fine-needle aspiration was performed in a heterogeneous hypoechoic mass located at pancreatic head. Cell block with immunohistochemistry was positive for thyroglobulin, suggesting papillary thyroid carcinoma metastasis. The patient still survives at present, treating metastasis with Cabozantinib. Conclusion endoscopic ultrasound fine-needle aspiration is a minimally invasive and accurate method of sampling lesions of the pancreas. In combination with clinical history and immunohistochemistry, can confirm diagnosis and define management.- UNDERWATER ENDOSCOPIC MUCOSAL RESECTION FOR NON-PEDUNCULATED COLORECTAL LESIONS. A PROSPECTIVE SINGLE-ARM STUDY(2020) LENZ, Luciano; MARTINS, Bruno; KAWAGUTI, Fabio Shiguehisa; TELLIAN, Alexandre; PENNACHI, Caterina Maria Pia Simoni; SORBELLO, Mauricio; GUSMON, Carla; PAULO, Gustavo Andrade de; UEMURA, Ricardo; GEIGER, Sebastian; LIMA, Marcelo Simas de; SAFATLE-RIBEIRO, Adriana; BABA, Elisa; HASHIMOTO, Claudio Lyoiti; MALUF-FILHO, Fauze; RIBEIRO JR, UlyssesABSTRACT BACKGROUND: Underwater endoscopic mucosal resection (UEMR) has emerged as a revolutionary method allowing resection of colorectal lesions without submucosal injection. Brazilian literature about this technique is sparse. OBJECTIVE: The aim of this study was evaluate the efficacy and safety of UEMR technique for removing non-pedunculated colorectal lesions in two Brazilian tertiary centers. METHODS: This prospective study was conducted between June 2016 and May 2017. Naïve and non-pedunculated lesions without signs of submucosal invasion were resected using UEMR technique. RESULTS: A total of 55 patients with 65 lesions were included. All lesions, except one, were successfully and completely removed by UEMR (success rate 98.5%). During UEMR, two cases of bleeding were observed (3.0%). One patient had abdominal pain on the day after resection without pneumoperitoneum. There was no perforation or delayed bleeding. CONCLUSION: This study supports the existing data indicating acceptable rates of technical success, and low incidence of adverse events with UEMR. The results of this Brazilian study were consistent with previous abroad studies.