JOAO ANTONIO DIAS JUNIOR
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- Laparoscopic Management of Pregnancy in a Patient with Uterus Didelphys - Reply(2012) BASSI, Marco Antonio; PODGAEC, Sergio; DIAS JR., Joao Antonio; D'AMICO FILHO, Nicolau; PETTA, Carlos Alberto; ABRAO, Mauricio S.
- Quality of Life after Segmental Resection of the Rectosigmoid by Laparoscopy in Patients with Deep Infiltrating Endometriosis with Bowel Involvement(2011) BASSI, Marco Antonio; PODGAEC, Sergio; DIAS JR., Joao Antonio; D'AMICO FILHO, Nicolau; PETTA, Carlos Alberto; ABRAO, Mauricio S.Study Objective: To estimate the quality of life of patients undergoing laparoscopic resection of a segment of the rectosigmoid for the treatment of deep infiltrating endometriosis with bowel involvement. Design: Prospective application of the SF-36 Health Status Questionnaire to 151 women before and 1 year after surgical intervention (Canadian Task Force Design Classification II). Setting: Department of Obstetrics and Gynecology, University of Sao Paulo Medical School, and Samaritano Hospital, Sao Paulo, Brazil. Patients: A total of 151 women (mean age 34.05 +/- 5.65 years) with deep infiltrating endometriosis underwent resection of a segment of the rectosigmoid by laparoscopy between 2002 to 2009. Interventions: All the patients had historical data collected and underwent clinical examination and transvaginal ultrasonography with prior bowel preparation for resection of a segment of the rectosigmoid by laparoscopy indicated for patients with symptoms (pelvic pain) with 1 or more lesions of more than 3 cm in length or multifocal lesions. Measurements and Main Results: Wilcoxon signed rank test verified differences between the degrees of the symptoms and the SF-36 scores before and 1 year after laparoscopic treatment. There was a significant improvement (p < .001) in all pain-related symptoms, as well as a significant increase (p < .001) in scores in all the SF-36 domains and in the sum of the components comprising both physical and mental health. Conclusion: Laparoscopic segmental resection of the rectosigmoid fulfills its essential objective of treating endometriosis with bowel involvement and improving patients' QoL to a significant extent. Journal of Minimally Invasive Gynecology (2011) 18, 730-733 (C) 2011 AAGL. All rights reserved.
- Patients With Endometriosis of the Rectosigmoid Have a Higher Percentage of Natural Killer Cells in Peripheral Blood(2012) DIAS JR., Joao Antonio; PODGAEC, Sergio; OLIVEIRA, Ricardo Manoel de; MARIN, Maria Lucia Carnevale; BARACAT, Edmund Chadad; ABRAO, Mauricio SimoesStudy Objective: To estimate the concentration of natural killer (NK) cells in the peripheral blood in patients with and without endometriosis. Design: Case-control study (Canadian Task Force classification II-2). Setting: Tertiary referral hospital. Patients: One hundred fifty-five patients who had undergone videolaparoscopy were divided into 2 groups: those with endometriosis (n = 100) and those without endometriosis (n = 55). Interventions: The percentage of NK cells relative to peripheral lymphocytes was quantified at flow cytometry in 155 patients who had undergone laparoscopy. In addition to verifying the presence of endometriosis, stage of disease and the sites affected were also evaluated. Measurements and Main Results: The mean (SD) percentage of NK cells was higher (15.3% [9.8%]) in patients with endometriosis than in the group without the disease (10.6% [5.8%]) (p < .001). The percentage of NK cells was highest (19.8 [10.3%]) in patients with advanced stages of endometriosis and in those in whom the rectosigmoid colon was affected. In a statistical model of probability, the association of this marker (NK cells >= 11%) with the presence of symptoms such as pain and intestinal bleeding during menstruation and the absence of previous pregnancy yielded a 78% likelihood of the rectosigmoid colon being affected. Conclusion: Compared with patients without endometriosis, those with endometriosis demonstrate a higher concentration of peripheral NK cells. The percentage of NK cells is greater, primarily in patients with advanced stages of endometriosis involving the rectosigmoid colon. Therefore, it may serve as a diagnostic marker for this type of severe endometriosis, in particular if considered in conjunction with the symptoms. Journal of Minimally Invasive Gynecology (2012) 19, 317-324 (C) 2012 AAGL. All rights reserved.