FABIO SHIGUEHISSA KAWAGUTI

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12
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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico

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Agora exibindo 1 - 10 de 22
  • article 16 Citação(ões) na Scopus
    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, Fauze
    Background 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.
  • article 3 Citação(ões) na Scopus
    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.
  • article
    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, Fauze
    Introduction 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.
  • conferenceObject
    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, Fauze
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    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, Fauze
  • article
    Two-step ESD: an option for en-bloc resection of extensive colorectal laterally spreading tumors
    (2019) KAWAGUTI, Fabio S.; OKAZAKI, Ossamu; MIYAJIMA, Nelson T.; SEGATELI, Vanderlei; MARQUES, Carlos F. S.; NAHAS, Caio S. R.; MARTINS, Bruno C.; NAHAS, Sergio C.; JUNIOR, Ulysses R.; FILHO, Fauze M.
    Background and study aims Endoscopic submucosal dissection (ESD) is considered feasible and safe for treatment of colorectal laterally spreading tumors (LST), However it remains a challenge in case of extensive lesions even for experts. This study aimed to describe a new method to facilitate ESD of extensive colorectal LSTs. Between July 2010 and January 2018, 140 patients underwent ESD for colorectal LSTs. Four of them were submitted to two-step ESD and were included in this retrospective study. The submucosal dissection of lesions larger than 12 cm started and continued until the medical team decided to pause the procedure and continue it in a second step. The second procedure was performed 2 days after to finish the en-bloc resection.Three patients were male, with mean age of 67.2y (+/- 2.2). All lesions were located in the rectum, with a mean size of 153.7 mm (+/- 33.8). En-bloc and curative resection were successfully achieved in all cases. Mean duration of the first step of the procedure was 255 minutes (+/- 61.8), and mean duration of the second step was 205 minutes (+/- 205). Overall mean duration of both steps was 460 minutes (+/- 168). Mean dissected area in the first step of the procedure was approximately 55 % of the lesion. No adverse events were observed. In conclusion, our results suggest that performing ESD in two steps could be a feasible and safe option for exceptional cases in which is not possible to finish the procedure in one step, avoiding the morbidity of surgical treatment.
  • conferenceObject
    ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTROINTESTINAL TUMORS - INITIAL EXPERIENCE AT A BRAZILIAN INSTITUTION
    (2023) FRANCO, Matheus; SOUSA, Rhamon De; KAWAGUTI, Fabio; GUEDES, Hugo; COSTA, Lucas Nova Da; STEVENS, Tyler; MIYAJIMA, Nelson; MALUF-FILHO, Fauze; VARGO, John; BHATT, Amit
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    THE ROLE OF PROBE-BASED CONFOCAL ENDOMICROSCOPY (PCLE) IN THE DIAGNOSIS OF SUSTAINED CLINICAL COMPLETE RESPONSE UNDER WATCH-AND-WAIT STRATEGY AFTER NEOADJUVANT CHEMORADIOTHERAPY FOR LOCALLY ADVANCED RECTAL ADENOCARCINOMA
    (2022) SAFATLE-RIBEIRO, Adriana V.; LATA, John; FERREIRA, Marina Tucci Gammaro Baldavira; FLOR, Marcelo M.; PEREZ, Caio; BABA, Elisa R.; LENZ, Luciano H.; MARTINS, Bruno Da Costa; KAWAGUTI, Fabio S.; PAULO, Gustavo A. De; LIMA, Marcelo S. De; MOURA, Renata N.; PENNACCHI, Caterina; GUSMON, Carla; GEIGER, Sebastian; UEMURA, Ricardo; NAHAS, Caio Sergio R.; MARQUES, Carlos F.; IMPERIALE, Antonio R.; COTTI, Guilherme C.; RIBEIRO, Ulysses; MALUF-FILHO, Fauze; NAHAS, Sergio C.
  • article 0 Citação(ões) na Scopus
    Comparing three-dimensional endorectal ultrasound and magnification chromoendoscopy for early rectal neoplasia invasion depth assessment
    (2024) PINTO, Rodrigo Ambar; KAWAGUTI, Fabio Shiguehissa; KIMURA, Cintia Mayumi Sakurai; CORREA NETO, Isaac Jose Felippe; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; BUSTAMANTE-LOPEZ, Leonardo Alfonso; RIBEIRO-JR, Ulysses; MALUF-FILHO, Fauze; NAHAS, Sergio Carlos
    IntroductionAccurate assessment of invasion depth of early rectal neoplasms is essential for optimal therapy. We aimed to compare three-dimensional endorectal ultrasound (3D-ERUS) with magnification chromoendoscopy (MCE) regarding their accuracy in assessing parietal invasion depth (T).MethodsPatients with middle and distal rectum neoplasms were prospectively included. Two providers blinded to each other's assessment performed 3D-ERUS and MCE, respectively. The T stage assessed through ERUS was compared to the MCE evaluation. The results were compared to the surgical specimen anatomopathological report. Sensitivity, specificity, accuracy, positive (PPV), and negative (NPV) predictive values were calculated for the T stage and for the final therapy (local excision or radical surgery).ResultsIn 8 years, 70 patients were enrolled, and all underwent both exams. MCE and ERUS showed an accuracy of 94.3% and 85.7%, sensitivity of 83.7 and 93.3%, specificity of 96.4 and 83.6%, PPV of 86.7 and 60.9%, and NPV of 96.4 and 97.9%, respectively. Kappa for T stage assessed through ERUS was 0.64 and 0.83 for MCE.ConclusionMCE and 3D-ERUS had good diagnostic performance, but the endoscopic method had higher accuracy. Both methods reliably assessed lesion extension, circumferential involvement, and distance from the anal verge.
  • conferenceObject
    ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTROINTESTINAL TUMORS - INITIAL EXPERIENCE AT A BRAZILIAN INSTITUTION
    (2023) FRANCO, Matheus; SOUSA, Rhamon De; KAWAGUTI, Fabio; GUEDES, Hugo; COSTA, Lucas Nova Da; STEVENS, Tyler; MIYAJIMA, Nelson; MALUF-FILHO, Fauze; VARGO, John; BHATT, Amit