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
75 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 75
- Comparison of the pull and introducer percutaneous endoscopic gastrostomy techniques in patients with head and neck cancer(2017) RETES, Felipe A.; KAWAGUTI, Fabio S.; LIMA, Marcelo S. de; MARTINS, Bruno da Costa; UEMURA, Ricardo S.; PAULO, Gustavo A. de; PENNACCHI, Caterina M. P.; GUSMON, Carla; RIBEIRO, Adriana V. S.; BABA, Elisa R.; GEIGER, Sebastian N.; SORBELLO, Mauricio P.; KULCSAR, Marco A.; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground and study aims: Percutaneous endoscopic gastrostomy (PEG) in head and neck cancer (HNC) patients is associated with higher complication and mortality rates when compared to a general patient population. The pull technique is still the preferred technique worldwide but it has some limitations. The aim of this study is to compare the pull and introducer PEG techniques in patients with HNC. Patients and methods: This study is based on a retrospective analysis of a prospectively collected database of 309 patients with HNC who underwent PEG in the Cancer Institute of SAo Paulo. Results: The procedure was performed with the standard endoscope in 205 patients and the introducer technique was used in 137 patients. There was one procedure-related mortality. Age, sex and albumin level were similar in both groups. However in the introducer technique group, patients had a higher tumor stage, a lower Karnofsky status, and presented more frequently with tracheostomy and trismus. Overall, major, minor, immediate and late complications and 30-day mortality rates were similar but the introducer technique group presented more minor bleeding and tube dysfunctions. Conclusion: The push and introducer PEG techniques seem to be both safe and effective but present different complication profiles. The choice of PEG technique in patients with HNC should be made individually.
- 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.
- Etiology, endoscopic management and mortality of upper gastrointestinal bleeding in patients with cancer(2013) MALUF-FILHO, Fauze; MARTINS, Bruno da Costa; LIMA, Marcelo Simas de; LEONARDO, Daniel Valdivia; RETES, Felipe Alves; KAWAGUTI, Fabio Shiguehissa; SATO, Cezar Fabiano Manabu; HONDO, Fabio Yuji; SAFATLE-RIBEIRO, Adriana Vaz; RIBEIRO JR., UlyssesBackground: The source and outcomes of upper gastrointestinal bleeding (UGIB) in oncologic patients are poorly investigated. Objective: The study aimed to investigate these issues in a tertiary academic referral center specialized in cancer treatment. Methods: This was a retrospective study including all patients with cancer referred to endoscopy due to UGIB in 2010. Results: UGIB was confirmed in 147 (of 324 patients) referred to endoscopy for a suspected episode of GI bleeding. Tumor was the most common cause of bleeding (N = 35, 23.8%), followed by varices (N = 30, 19.7%), peptic ulcer (N = 29, 16.3%) and gastroduodenal erosions (N = 16, 10.9%). Among the 32 patients with cancer of the upper GI tract, the main causes of bleeding were cancer (N = 27, 84.4%) and peptic ulcer (N = 5, 6.3%). Forty-one patients (27.9%) presented with bleeding from the primary tumor or from a metastatic lesion, and seven received endoscopic therapy, with successful initial hemostasis in six (85.7%). Rebleeding and mortality rates were not different between endoscopically treated (N = 7) and nontreated (N = 34) patients (28.6% vs. 14.7%, p = 0.342; 43.9% vs. 44.1%, p = 0.677). Median survival was 20 days, and the overall 30-day mortality rate was 44.9%. There was no predictive factor of mortality or rebleeding. Conclusion: Tumor bleeding is the most common cause of UGIB in cancer patients. UGIB in cancer patients correlates with a high mortality rate regardless of the bleeding source. Current endoscopic treatments may not be effective in preventing rebleeding or improving survival.
- 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, Fauze