FAUZE MALUF FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
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- EUS-guided gastroenterostomy: Initial experience in a brazilian tertiary center(2020) OLIVEIRA, Joel Fernandez de; CORDERO, Martin Andres Coronel; LIMA, Gustavo Rosa de Almeida; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas de; MARTINS, Bruno da Costa; JR, Ulysses Ribeiro; MALUF-FILHO, FauzeINTRODUCTION: EUS-guided gastroenterostomy (EUS-GE) is a novel procedure for palliation of malignant gastric outlet obstruction (GOO). Our aim was to evaluate the outcomes of this technique in our initial experience. METHODS: Patients with GOO from our institute were included. Technical success was defined as the successful creation of a gastroenterostomy. Clinical success was defined as the ability to tolerate a soft diet after the procedure. We assessed adverse events and diet tolerance 1 month after the procedure. RESULTS: Three patients were included. Technical and clinical success was achieved in all cases. There were no adverse events and good diet tolerance was observed 1 month after the procedure in the included patients. CONCLUSION: EUS-GE is a promising treatment for patients with GOO.
- Opinion: How to manage subepithelial lesions of the upper gastrointestinal tract?(2015) FRANCO, Matheus Cavalcante; SCHULZ, Ricardo Teles; MALUF-FILHO, FauzeSubepithelial lesions (SELs) in the upper gastrointestinal (GI) tract are relatively frequent findings in patients undergoing an upper GI endoscopy. These tumors, which are located below the epithelium and out of reach of conventional biopsy forceps, may pose a diagnostic SELs are indeterminate after endoscopy and endoscopic ultrasound (EUS). The decision to proceed with further investigation should take into consideration the size, location in the GI tract, and EUS features of SELs. Gastrointestinal stromal tumor (GIST) is an example of an SEL that has a well-recognized malignant potential. Unfortunately, EUS is not able to absolutely differentiate GISTs from other benign hypoechoic lesions from the fourth layer, such as leiomyomas. Therefore, EUS-guided fine needle aspiration (EUS-FNA) is an important tool for correct diagnosis of SELs. However, small lesions (size < 2 cm) have a poor diagnostic yield with EUS-FNA. Moreover, studies with EUS-core biopsy needles did not report higher rates of histologic and diagnostic yields when compared with EUS-FNA. The limited diagnostic yield of EUS-FNA and EUS-core biopsies of SELs has led to the development of more invasive endoscopic techniques for tissue acquisition. There are initial studies showing good results for tissue biopsy or resection of SELs with endoscopic submucosal dissection, suck-ligate-unroof-biopsy, and submucosal tunneling endoscopic resection.
- Pancreatic endosonographic findings and clinical correlation in Crohn's disease(2019) MALLUTA, Everson Fernando; MALUF-FILHO, Fauze; LEITE, Andre Zonetti de Arruda; ORTIZ-AGOSTINHO, Carmen Lucia; NISHITOKUKADO, Lecia; ANDRADE, Adriana Ribas; LORDELLO, Maria Laura Lacava; SANTOS, Fabiana Maria dos; SIPAHI, Aytan MirandaOBJECTIVES: We aimed to evaluate the incidence of pancreatic alterations in Crohn's disease using endoscopic ultrasound (EUS) and to correlate the number of alterations with current clinical data. METHODS: Patients diagnosed with Crohn's disease (n= 51) were examined using EUS, and 11 variables were analyzed. A control group consisted of patients with no history of pancreatic disease or Crohn's disease. Patients presenting with three or more alterations underwent magnetic resonance imaging (MRI). Pancreatic function was determined using a fecal elastase assay. RESULTS: Two of the 51 patients (3.9%) presented with four EUS alterations, 3 (5.9%) presented with three, 11 (21.5%) presented with two, and 13 (25.5%) presented with one; in the control group, only 16% presented with one EUS alteration (p< 0.001). Parenchymal abnormalities accounted for 39 of the EUS findings, and ductal abnormalities accounted for 11. Pancreatic lesions were not detected by MRI. Low fecal elastase levels were observed in 4 patients, none of whom presented with significant pancreatic alterations after undergoing EUS. Ileal involvement was predictive of the number of EUS alterations. CONCLUSION: A higher incidence of pancreatic abnormalities was found in patients with Crohn's disease than in individuals in the control group. The majority of these abnormalities are related to parenchymal alterations. In this group of patients, future studies should be conducted to determine whether such morphological abnormalities could evolve to induce exocrine or endocrine pancreatic insufficiency and, if so, identify the risk factors and determine which patients should undergo EUS.
- Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy(2020) SCOMPARIN, Rodrigo Corsato; MARTINS, Bruno Costa; LENZ, Luciano; BENTO, Luiza Haendchen; MARQUES, Carlos Sparapam; SAFATLE-RIBEIRO, Adriana; JR, Ulysses Ribeiro; NAHAS, Sergio Carlos; MALUF-FILHO, FauzeThe use of colorectal self-expanding metal stents (SEMS) as bridge therapy for malignant colorectal obstruction was first reported more than 20 years ago. However, its use remains controversial. OBJECTIVE: In this study, we aimed to compare the long-term survival of patients with potentially resectable malignant colorectal obstruction who had undergone colorectal SEMS placement and emergency surgery. METHODS: This study was a retrospective analyses. Patients who received treatment between 2009 and 2017 were included. According to the eligibility criteria, 21 patients were included in the SEMS group and 67 patients were included in the surgical group. RESULTS: The majority of the patients in the SEMS group were female (57.1%), whereas the majority of those in the surgical group were male (53.7%). The median follow-up time was 60 months for both groups with the same interquartile range of 60 months. There was no difference in the overall survival rate (log rank p=0.873) and disease-free survival rate (log rank p=0.2821) in the five-year analysis. There was no difference in local recurrence rates (38.1% vs. 22.4%, p=0.14) or distant recurrence rates (33.3% vs. 50.7%, p=0.16) in the SEMS and the surgical groups. Technical and clinical success rates of endoscopic stenting were 95.3% and 85.7%, respectively. There were no immediate adverse events (AEs). Severe AEs included perforation (14.3%), silent perforation (4.7%), reobstruction (14.3%), and bleeding (14.3%). Mild AEs included pain (42.8%), tenesmus (9.5%), and incontinence (4.76%). The limitations of this study was retrospective and was conducted at a single center. CONCLUSIONS: No differences in disease-free and overall survival rates were observed in the five-year analysis of patients with resectable colorectal cancer who had undergone SEMS placement or colostomy for the treatment of malignant colorectal obstruction. Patients in the SEMS group had a higher rate of primary anastomosis and a lower rate of temporary colostomy than did those in the surgery group.
- Results of endoscopic biliary drainage in patients with malignant hilar stricture(2023) MARTINS, Bruno Costa; PEREZ, Caio A.; RUAS, Jennifer N.; BENTO, Luiza H.; MENDONCA, Ernesto Q.; PAULO, Gustavo A. de; UEMURA, Ricardo S.; GEIGER, Sebastian N.; LIMA, Marcelo Simas de; JUKEMURA, Jose; JR, Ulysses Ribeiro; MALUF-FILHO, FauzeIn Malignant Hilar Biliary Stricture (MHBS) palliative biliary drainage is a frequent strategy, improving the qual-ity of life, reducing pruritus, loss of appetite and relieving cholangitis. The endoscopic approach is an effective, although challenging procedure. This study aimed to evaluate technical and clinical success rates of biliary drain-age by ERCP. This is a retrospective study including all patients with MHBS referred to Instituto do Cancer do Hos-pital de Sao Paulo (ICESP) submitted to biliary drainage by ERCP, between January 2010 and December 2017. Multivariable logistic regression was performed to evaluate predictors of clinical failure, as total bilirubin levels, Bismuth classification, number of hepatic sectors drained and presence of cholangitis. In total, 82 patients pre-senting unresectable MHBS were included in this study. 58.5% female and 41.5% male, with a mean age of 60 +/- 13 years. Bismuth classification grades II, IIIA, IIIB and IV were noted in 23.2%, 15.9%, 14.6% and 46.3%, respectively. Technical and clinical success was achieved in 92.7% and 53.7% respectively. At multivariable logis-tic-regression analyses, Bismuth IV strictures were related to higher clinical failure rates when compared to other strictures levels, with an Odds Ratio of 5.8 (95% CI 1.28-20.88). In conclusion, endoscopic biliary drainage for malignant hilar biliary stricture had a high technical success but suboptimal clinical success rate. Proximal stric-tures (Bismuth IV) were associated with poor drainage outcomes.
- Validation of classic and expanded criteria for endo-scopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center(2018) MENDONCA, Ernesto Quaresma; PESSORRUSSO, Fernanda Cristina Simoes; RAMOS, Marcus Fernando Kodama Pertille; JACOB, Carlos Eduardo; OLIVEIRA, Joel Fernandez de; RIBEIRO, Maria Sylvia; SAFATLE-RIBEIRO, Adriana; ZILBERSTEIN, Bruno; RIBEIRO JUNIOR, Ulysses; MALUF-FILHO, FauzeOBJECTIVE: Our aim was to evaluate the Japan Gastroenterological Endoscopy Society criteria for endoscopic submucosal resection of early gastric cancer (EGC) based on the experience in a Brazilian cancer center. METHODS: We included all patients who underwent endoscopic submucosal resection for gastric lesions between February 2009 and October 2016. Demographic data and information regarding the endoscopic resection, pathological report and follow-up were obtained. Statistical calculations were performed with Fisher's exact test and chi-square tests, with 95% confidence intervals. RESULTS: In total, 76% of the 51 lesions were adenocarcinomas, 16% were adenomas, and 8% had other diagnoses. The average size was 19.9 mm (+/- 11.7). The average procedure length was 113.9 minutes (+/- 71.4). The complication rate was 21.3%, with only one patient who needed surgical treatment (transmural perforation). Among the adenocarcinomas, 39.5% met the classic criteria for curability, 31.6% met the expanded criteria and 28.9% met the criteria for noncurative resection. Analysis of the indication criteria and curability revealed differences among cases with ""only-by-size"" expanded criteria (64.28%), other expanded criteria (40%) and classic criteria (89.47%), with a p-value of 0.049. During follow-up (15.8 months; +/- 14.3), 86.1% of the EGC patients had no recurrence. When well-differentiated and poorly differentiated lesions or lesions included in the classic and expanded criteria were compared, there were no differences in recurrence. The noncurative group presented a higher recurrence rate than the classic group (p=0.014). CONCLUSION: These results suggest that the Japanese endoscopic submucosal resection criteria might be useful for endoscopic treatment of EGC in Western countries.
- Modified Nissen fundoplication: laparoscopic anti-reflux surgery after Roux-en-Y gastric bypass for obesity(2012) KAWAHARA, Nilton T.; ALSTER, Clarissa; MALUF-FILHO, Fauze; POLARA, Wilson; CAMPOS, Guilherme M.; POLI-DE-FIGUEIREDO, Luiz Francisco
- Strongyloides stercoralis hyperinfection: an unusual cause of gastrointestinal bleeding(2015) RIOS, Juliana Trazzi; FRANCO, Matheus Cavalcante; MARTINS, Bruno da Costa; BABA, Elisa Ryoka; SAFATLE-RIBEIRO, Adriana Vaz; SAKAI, Paulo; RETES, Felipe Alves; MALUF-FILHO, FauzeStrongyloidiasis is a parasitic disease that may progress to a disseminated form, called hyperinfection syndrome, in patients with immunosuppression. The hyperinfection syndrome is caused by the wide multiplication and migration of infective larvae, with characteristic gastrointestinal and/or pulmonary involvement. This disease may pose a diagnostic challenge, as it presents with nonspecific findings on endoscopy.
- Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group(2019) BARKUN, Alan N.; ALMADI, Majid; KUIPERS, Ernst J.; LAINE, Loren; SUNG, Joseph; TSE, Frances; I, Grigorios Leontiadis; ABRAHAM, Neena S.; CALVET, Xavier; CHAN, Francis K. L.; DOUKETIS, James; ENNS, Robert; GRALNEK, Ian M.; JAIRATH, Vipul; JENSEN, Dennis; LAU, James; LIP, Gregory Y. H.; LOFFROY, Romaric; MALUF-FILHO, Fauze; MELTZER, Andrew C.; REDDY, Nageshwar; SALTZMAN, John R.; MARSHALL, John K.; BARDOU, MarcDescription: This update of the 2010 International Consensus Recommendations on the Management of Patients With Non-variceal Upper Gastrointestinal Bleeding (UGIB) refines previous important statements and presents new clinically relevant recommendations. Methods: An international multidisciplinary group of experts developed the recommendations. Data sources included evidence summarized in previous recommendations, as well as systematic reviews and trials identified from a series of literature searches of several electronic bibliographic databases from inception to April 2018. Using an iterative process, group members formulated key questions. Two methodologists prepared evidence profiles and assessed quality (certainty) of evidence relevant to the key questions according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Group members reviewed the evidence profiles and, using a consensus process, voted on recommendations and determined the strength of recommendations as strong or conditional. Recommendations: Preendoscopic management: The group suggests using a Glasgow Blatchford score of 1 or less to identify patients at very low risk for rebleeding, who may not require hospitalization. In patients without cardiovascular disease, the suggested hemoglobin threshold for blood transfusion is less than 80 g/L, with a higher threshold for those with cardiovascular disease. Endoscopic management: The group suggests that patients with acute UGIB undergo endoscopy within 24 hours of presentation. Thermocoagulation and sclerosant injection are recommended, and clips are suggested, for endoscopic therapy in patients with high-risk stigmata. Use of TC-325 (hemostatic powder) was suggested as temporizing therapy, but not as sole treatment, in patients with actively bleeding ulcers. Pharmacologic management: The group recommends that patients with bleeding ulcers with high-risk stigmata who have had successful endoscopic therapy receive high-dose proton-pump inhibitor (PPI) therapy (intravenous loading dose followed by continuous infusion) for 3 days. For these high-risk patients, continued oral PPI therapy is suggested twice daily through 14 days, then once daily for a total duration that depends on the nature of the bleeding lesion. Secondary prophylaxis: The group suggests PPI therapy for patients with previous ulcer bleeding who require antiplatelet or anticoagulant therapy for cardiovascular prophylaxis.
- Application of confocal endomicroscopy in the diagnostic elucidation of pancreatic cyst(2018) SCOMPARIN, Rodrigo C.; BENTO, Luiza H.; BATISTA, Clelma P.; MARTINS, Bruno C.; LENZ, Luciano; BABA, Elisa R.; SAFATLE-RIBEIRO, Adriana Vaz; MALUF-FILHO, Fauze