SERGIO HENRIQUE BASTOS DAMOUS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
34 resultados
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- Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches(2016) UTIYAMA, Edivaldo Massazo; DAMOUS, Sergio Henrique Bastos; TANAKA, Eduardo Yassushi; YOO, Jin Hwan; MIRANDA, Jocielle Santos de; USHINOHAMA, Adriano Zuardi; FARO JR., Mario Paulo; BIROLINI, Claudio Augusto ViannaBACKGROUND: The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair ( LTE) with a single mesh and without staple fixation. PATIENTS AND METHODS: This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of Sao Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: ( 1) The intensity of surgical trauma, operation time, C-reactive protein ( CRP) levels, white blood cell count, bleeding and pain intensity; ( 2) quality of life assessment; and ( 3) post-operative complications. RESULTS: LTE procedure was longer than the Stoppa procedure ( 134.6 min +/- 38.3 vs. 90.6 min +/- 41.3; P < 0.05). The levels of CRP were higher in the Stoppa group ( P < 0.05) but the number of leucocytes, haematocrit, and haemoglobin were similar between the groups ( P > 0.05). There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative ( P > 0.05). Complications occurred in 88% of Stoppa group ( 22 patients) and 64% in LTE group ( 16 patients) ( P < 0.05). CONCLUSION: The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: ( 1) The LTE approach showed less surgical trauma despite the longer operation time; ( 2) Quality of life during the early post-operative period were similar; and ( 3) Complication rates were higher in the Stoppa group.
- Polypropylene and polypropylene/polyglecaprone (Ultrapro(r)) meshes in the repair of incisional hernia in rats(2015) UTIYAMA, Edivaldo Massazo; ROSA, Maria Beatriz Sartor de Faria; ANDRES, Marina de Paula; MIRANDA, Jocielle Santos de; DAMOUS, Sérgio Henrique Bastos; BIROLINI, Cláudio Augusto Vianna; DAMOUS, Luciana Lamarão; MONTERO, Edna Frasson de SouzaPURPOSE: To compare the inflammatory response of three different meshes on abdominal hernia repair in an experimental model of incisional hernia. METHODS: Median fascial incision and skin synthesis was performed on 30 Wistar rats. After 21 days, abdominal hernia developed was corrected as follows: 1) No mesh; 2) Polypropylene mesh; and, 3) Ultrapro(r) mesh. After 21 days, the mesh and surrounding tissue were submitted to macroscopic (presence of adhesions, mesh retraction), microscopic analysis to identify and quantify the inflammatory and fibrotic response using a score based on a predefined scale of 0-3 degrees, evaluating infiltration of macrophages, giant cells, neutrophils and lymphocytes. RESULTS: No significant difference was seen among groups in adherences, fibrosis, giant cells, macrophages, neutrophils or lymphocytes (p>0.05). Mesh shrinkage was observed in all groups, but also no difference was observed between polypropylene and Ultrapro mesh (7.0±9.9 vs. 7.4±10.1, respectively, p=0.967). Post-operatory complications included fistula, abscess, dehiscence, serohematic collection and reherniation, but with no difference among groups (p=0.363). CONCLUSION: There is no difference between polypropylene (high-density) and Ultrapro(r) (low-density) meshes at 21 days after surgery in extraperitoneal use in rats, comparing inflammatory response, mesh shortening, adhesions or complications.
- Challenges to implement laparoscopic appendectomy as the first-line treatment for acute appendicitis: a fifteen-year experience in a tertiary hospital in Brazil(2023) DAMOUS, SERGIO HENRIQUE BASTOS; MENEGOZZO, CARLOS AUGUSTO METIDIERI; ROCHA, MARCELO CRISTIANO; COLLET-E-SILVA, FRANCISCO SALLES; UTIYAMA, EDIVALDO MASSAZOABSTRACT Background: the barriers to implement emergency laparoscopy in public teaching hospitals involve issues such as resident learning curves and resource costs and availability. This study was designed to describe the issues facing the implementation of laparoscopic approach for acute appendicitis over 15 years in a single academic center in Brazil. Materials and Methods: retrospective study of patients undergoing emergency appendectomy from 2004 to 2018. Clinical data were compared to four major actions implemented in the emergency surgical service: minimally invasive surgery training for residents (2007), laparoscopic stump closure using metal clips (2008), 24/7 availability of laparoscopic instruments for emergency surgeries (2010), and third-party contract for maintenance of the laparoscopic instruments and implementation of polymeric clips for stump closure (2013). We evaluated the increase in laparoscopic appendectomy after the implementation of those major changes. Results: we identified 1168 appendectomies during the study period, of which 691 (59%), 465 (40%), and 12 (1%) were open, laparoscopic, and converted, respectively. The implementation of the major changes since 2004 resulted in an increase of laparoscopic appendectomies from 11% in 2007 to 80% in 2016. These actions were decisive in the widespread use of laparoscopy for acute appendicitis (p<0.001). The standardization of the hem-o-lok clip in the treatment of the appendiceal stump made the procedure more feasible, reducing the surgical time using laparoscopic access and increasing the team’s adherence, so that this became the route of choice in about 85% of cases in the period from 2014 to 2018, 80% performed by 3rd year resident physicians. No intraoperative complications were noted related to laparoscopic access, even in more complicated appendicitis. There was no mortality reported, no reoperations or readmissions to hospital during a 30-day postoperative period. Conclusion: the development of a feasible, reproducible, and safe technical standardization, associated with continuous cost optimization, are the cornerstones for a consistent and viable change in the current practice for appendectomies in middle and lower-income countries.
conferenceObject Bilateral Inguinal Hernia Repair and Male Fertility: A Randomized Clinical Trial Comparing Lichtenstein vs Laparoscopic Transabdominal Preperitoneal(2022) DAMOUS, Sergio H. B.; DAMOUS, Luciana L.; BORGES, Victor A.; FONTELLA, Amanda K.; MIRANDA, Jocielle S.; KOIKE, Marcia K.; SAITO, Osmar C.; BIROLINI, Claudio A. V.; UTIYAMA, Edivaldo M.- Bilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) technique(2023) DAMOUS, Sergio Henrique Bastos; DAMOUS, Luciana Lamarao; BORGES, Victor Andre; FONTELLA, Amanda Karsburg; MIRANDA, Jocielle dos Santos; KOIKE, Marcia Kiyomi; SAITO, Osmar Cassio; BIROLINI, Claudio Augusto Vianna; UTIYAMA, Edivaldo MassazoBackground The effects of hernia repair on testicular function remain uncertain, regardless of the technique used. Studies that analyze testicular volume and flow after hernia repair or hormonal measurements are scarce and show contradictory results. This study aimed to evaluate the impact of bilateral inguinal hernia repair on male fertility in surgical patients in whom the Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques were used.Methods A randomized clinical trial comparing open (Lichtenstein) versus laparoscopic (TAPP) hernia repair using polypropylene mesh was performed in 48 adult patients (20 to 60 years old) with primary bilateral inguinal hernia. Patients were evaluated preoperatively and 90 and 180 postoperative (PO) days. Sex hormones (Testosterone, FSH, LH and SHGB) analysis, testicular ultrasonography, semen quality sexual activity changes and quality of life (QoL) were performed. Postoperative pain was evaluated using the visual analog scale (VAS).Results Thirty-seven patients with aged of 44 +/- 11 years were included, 19 operated on Lichtenstein and 18 operated on TAPP. The surgical time was similar between techniques. The pain was greater in the Lichtenstein group on the 7th PO day. The biochemical and hormonal analyses, testicular ultrasonography (Doppler, testicular volume, and morphological findings) and sperm quality were similar between groups. However, the sperm morphology was better in the Lichtenstein group after 180 days (p < 0.05 vs. preoperative) and two patients who underwent Lichtenstein hernia repair had oligospermia after 180 days. The QoL evaluation showed a significant improvement after surgery in the following domains: physical function, role emotional, bodily pain and general health (p < 0.05). On comparison of Lichtenstein vs. TAPP none of the domains showed statistically significant differences. No patient reported sexual changes.Conclusion Bilateral inguinal hernia repair with polypropylene mesh, whether using Lichtenstein or TAPP, does not impair male fertility in terms of long-term outcomes.Trial registration: Approved by the Ethics Committee for the Analysis of Research Projects (CAPPesq) of the HC/FMUSP, Number 2.974.457, in June 2015, Registered on Plataforma Brasil in October 2015 under Protocol 45535015.4.0000.0068. Registered on Clinicaltrials.gov, NCT 05799742. Enrollment of the first subject in January 2016.
bookPart Conduta Normativa no Politraumatizado(2013) UTIYAMA, Edivaldo Massazo; NOVO, Fernando da Costa Ferreira; DAMOUS, Sérgio Henrique Bastos- Which Model is Better to Teach How to Perform Tube Thoracostomy: Synthetic, Cadaver, or Animal?(2022) MEYER-PFLUG, Adriano Ribeiro; RASSLAN, Roberto; USSAMI, Edson Yassushi; SILVA, Francisco de Salles Collet e; OTOCH, Jose Pinhata; DAMOUS, Sergio Henrique Bastos; MONTERO, Edna Frasson de Souza; MENOGOZZO, Carlos Augusto Metidieri; VIEIRA, Joaquim Edson; UTIYAMA, Edivaldo MassazoIntroduction: The lack of standardized skill training reported by medical students in performing tube thoracostomies may be associated with higher complications. The ideal training model is yet to be determined. This study sought to evaluate three different models. Methods: Between 2015 and 2017, 204 last-year medical students of Universidade de Sao Paulo with no prior training in tube thoracostomy were randomized into three groups: cadaver, pig, and synthetic models. All groups performed 1-d tube thoracostomy hands-on training and a 40-min theoretical class. The knowledge acquisition was measured by a comparison between a theoretical test before and 3 wk after the class, and the skills improvement was evaluated by a comparison between the skills test on the same day of the hands-on training and another after 24 wk (the retention skill test). A questionnaire was submitted to evaluate their satisfaction rate and self-reported confidence, as per a Likert scale. Results: The theoretical post-test score was higher compared to the pretest score in all groups (P < 0.001). The retention skills test in the cadaver and synthetic groups decreased compared to the skills test (P = 0.01 and P = 0.007, respectively). There was no difference between the groups either in the theoretical test or in the skills test. Student satisfaction was higher in the cadaver and pig groups. The confidence perception increased in all groups after the training. Conclusions: The models used for tube thoracostomy training appear to have a similar impact on skills retention, knowledge acquisition, and confidence. Although the satisfaction rate is lower for the synthetic model, it has no biological risk or ethical issues and is more feasible. (C) 2022 Published by Elsevier Inc.
bookPart Laparoscopia no trauma: o caminho para a laparoscopia segura(2022) DAMOUS, Sérgio Henrique Bastos; BRINGEL, Eric Arcanjo; MENEGOZZO, Carlos Augusto Metidieri- Laparoscopic Surgery in Abdominal Trauma: Retrospective Study in a Trauma Center in Brazil(2017) MENEGOZZO, Carlos Augusto M.; DAMOUS, Sergio H. B.; ALVES, Pedro H. F.; BERNINI, Celso O.; UTIYAMA, Edivaldo
conferenceObject Effects of polypropylene mesh in testis and duct deferens in rats: a comparative study of two approaches(2015) UTIYAMA, Edivaldo M.; DAMOUS, Sergio H.; MIRANDA, Jocielle S.; SANDERS, Felipe Hada; PARDO, Maisa H.; PARDO, Maisa; MONTERO, Edna F. S.; DAMOUS, Luciana L.; DAMOUS, Luciana; BIROLINI, Claudio