CLAUDIO LYOITI HASHIMOTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
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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, FauzeconferenceObject Underwater Endoscopic Mucosal Resection for Non-Pendulated Colorectal Lesions. Is the Distal Cap Really Necessary?(2017) LENZ, Luciano; OLIVEIRA, Joel; MENDONCA, Ernesto Q.; GONZALEZ, Esteban H.; MINATA, Mauricio K.; PAULO, Gustavo A. de; GEIGER, Sebastian N.; SORBELLO, Mauricio; LIMA, Marcelo A.; KAWAGUTI, Fabio S.; MARTINS, Bruno da Costa; BABA, Elisa R.; SAFATLE-RIBEIRO, Adriana V.; GUSMON, Carla C.; PENNACCHI, Caterina; UEMURA, Ricardo S.; TELLIAN, Alexandre; ROLIM, Fausto; HASHIMOTO, Claudio; RIBEIRO, Ulysses; MALUF-FILHO, Fauze- UNDERWATER ENDOSCOPIC MUCOSAL RESECTION FOR NON-PEDUNCULATED COLORECTAL LESIONS. A PROSPECTIVE SINGLE-ARM STUDY(2020) LENZ, Luciano; MARTINS, Bruno; KAWAGUTI, Fabio Shiguehisa; TELLIAN, Alexandre; PENNACHI, Caterina Maria Pia Simoni; SORBELLO, Mauricio; GUSMON, Carla; PAULO, Gustavo Andrade de; UEMURA, Ricardo; GEIGER, Sebastian; LIMA, Marcelo Simas de; SAFATLE-RIBEIRO, Adriana; BABA, Elisa; HASHIMOTO, Claudio Lyoiti; MALUF-FILHO, Fauze; RIBEIRO JR, UlyssesABSTRACT BACKGROUND: Underwater endoscopic mucosal resection (UEMR) has emerged as a revolutionary method allowing resection of colorectal lesions without submucosal injection. Brazilian literature about this technique is sparse. OBJECTIVE: The aim of this study was evaluate the efficacy and safety of UEMR technique for removing non-pedunculated colorectal lesions in two Brazilian tertiary centers. METHODS: This prospective study was conducted between June 2016 and May 2017. Naïve and non-pedunculated lesions without signs of submucosal invasion were resected using UEMR technique. RESULTS: A total of 55 patients with 65 lesions were included. All lesions, except one, were successfully and completely removed by UEMR (success rate 98.5%). During UEMR, two cases of bleeding were observed (3.0%). One patient had abdominal pain on the day after resection without pneumoperitoneum. There was no perforation or delayed bleeding. CONCLUSION: This study supports the existing data indicating acceptable rates of technical success, and low incidence of adverse events with UEMR. The results of this Brazilian study were consistent with previous abroad studies.
- Underwater versus conventional EMR for nonpedunculated colorectal lesions: a randomized clinical trial(2023) LENZ, Luciano; MARTINS, Bruno; PAULO, Gustavo Andrade de; KAWAGUTI, Fabio Shiguehissa; BABA, Elisa Ryoka; UEMURA, Ricardo Sato; GUSMON, Carla Cristina; GEIGER, Sebastian Naschold; MOURA, Renata Nobre; PENNACCHI, Caterina; LIMA, Marcelo Simas de; SAFATLE-RIBEIRO, Adriana Vaz; HASHIMOTO, Claudio Lyoiti; RIBEIRO, Ulysses; MALUF-FILHO, FauzeBackground and aims: Conventional endoscopic mucosal resection (CEMR) is the standard modality for removing nonpedunculated colorectal lesions. Underwater endoscopic mucosal resection (UEMR) has emerged as an alternative method. There are few comparative studies between these techniques, especially evaluating recurrence. Therefore, the purpose of this trial was to compare CEMR and UEMR for the resection of colorectal lesions with respect to efficacy, safety, and recurrence rate. Methods: This was a randomized controlled trial of UEMR versus CEMR for naive and nonpedunculated lesions measuring between 10 and 40 mm. The primary outcome was adenoma recurrence at 6 months after the resec-tion. Secondary outcomes were rates of technical success, en bloc resection, and adverse events. Block random-ization was used to assign patients. Tattooing was performed to facilitate localization of the scars and eventual recurrences. Endoscopic follow-up was scheduled at 6 months after the procedure. The sites of resections were examined with white-light imaging, narrow-band imaging (NBI), and conventional chromoscopy with indigo carmine followed by biopsies. Results: One hundred five patients with 120 lesions were included, with a mean size of 17.5 +/- 7.1 (SD) mm. Sixty-one lesions were resected by UEMR and 59 by CEMR. The groups were similar at baseline regarding age, sex, average size, and histologic type. Lesions in the proximal colon in the CEMR group corresponded to 83% and in the UEMR group to 67.8% (P = .073). There was no difference between groups regarding success rate (1 failure in each group) and en bloc resection rate (60.6% UEMR vs 54.2% CEMR, P = .48). Intraprocedural bleeding was observed in 5 CEMRs (8.5%) and 2 UEMRs (3.3%) (P = .27). There was no perforation or delayed hemorrhage in either groups. Recurrence rate was higher in the CEMR arm (15%) than in the UEMR arm (2%) (P = .031). Therefore, the relative risk of 6-month recurrence rate in the CEMR group was 7.5-fold higher (95% CI, 0.98-58.20), with a number needed to treat of 7.7 (95% CI, 40.33-4.22). The higher recurrence rate in the CEMR group persisted only for lesions measuring 21 to 40 mm (35.7% vs 0%; P = .04). Conclusion: This study demonstrated that UEMR was associated with a lower adenoma recurrence rate than was CEMR. Both endoscopic techniques were effective and had similar rates of adverse events for the treatment of nonpedunculated colorectal lesions. (Gastrointest Endosc 2023;97:549-58.)