PAULO MANUEL PEGO FERNANDES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina - Líder
25 resultados
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- A New 3D CT Method to Analyze Bronchial Stenosis after Lung Transplantation(2019) DIAS, Y. T. Nunes; CHATE, R. C.; NOGUEIRA FILHO, J. M.; CIRILLO, G. G.; PEGO-FERNANDES, P. M.; SAMANO, M. N.
bookPart Derrame pericárdico(2019) ARAúJO, Pedro Henrique Xavier Nabuco de; PêGO-FERNANDES, Paulo Manuel- Impact of fundoplication for gastroesophageal reflux in the outcome of benign tracheal stenosis(2019) BIANCHI, Edno Tales; CARDOSO, Paulo Francisco Guerreiro; MINAMOTO, Helio; BIBAS, Benoit Jacques; SALATI, Michele; PEGO-FERNANDES, Paulo ManuelObjective: This study focuses on the impact of antireflux surgery in the outcome of tracheal stenosis. Methods: We performed a retrospective study including patients with benign tracheal stenosis who underwent esophageal manometry and dual-probe 24-hour ambulatory esophageal pH study. Patients with an abnormal pH study were managed with laparoscopic modified Nissen fundoplication or medically (omeprazole 80 mg/d, orally). Patients with normal pH study results were observed. After a 24-month follow-up, the outcome was considered satisfactory if tracheal stenosis could be managed by resection and there was no need for further dilatation or definitive decannulation. The management groups were compared using propensity score matching. Results: A total of 175 patients were included. Abnormal pH study results were found in 74 patients (42.3%), and 12.6% of patients had typical gastroesophageal reflux symptoms. Follow-up was completed in 124 patients (20 had fundoplication, 32 received omeprazole, and 72 were observed). After propensity score matching, the outcome of tracheal stenosis in the fundoplication group was similar to that of the observation group (odds ratio, 1; P = .99) and better than that of the omeprazole group (odds ratio, 5.31; P = .03). The observation (no gastroesophageal reflux) group had a better outcome of stenosis than those treated with omeprazole (odds ratio, 3.54; P = .02). Conclusions: The outcome of the airway stenosis was superior after laparoscopic fundoplication compared with medical treatment with omeprazole and was similar to the outcome of patients without gastroesophageal reflux. A prospective randomized trial is warranted.
- Segmentectomia pulmonar anatômica robótica: aspectos técnicos e desfechos(2019) TERRA, Ricardo Mingarini; LAURICELLA, Leticia Leone; HADDAD, Rui; DE-CAMPOS, José Ribas Milanes; NABUCO-DE-ARAUJO, Pedro Henrique Xavier; LIMA, Carlos Eduardo Teixeira; SANTOS, Felipe Carvalho Braga dos; PEGO-FERNANDES, Paulo ManuelABSTRACT Objective: to report our initial experience with pulmonary robotic segmentectomy, describing the surgical technique, the preferred positioning of portals, initial results and outcomes. Methods: we collected data, from a prospective robotic surgery database, on patients undergoing robotic segmentectomy between January 2017 and December 2018. All patients had lung cancer, primary or secondary, or benign diseases, and were operated on with the Da Vinci system, by the three portals technique plus one utilitarian incision of 3cm. We dissected the hilar structures individually and performed the ligatures of the arterial and venous branches, of the segmental bronchi, as well as a parenchymal transection, with endoscopic staplers. We carried out systematic dissection of mediastinal lymph nodes for non-small cell lung cancer (NSCLC) cases. Results: forty-nine patients, of whom 33 were women, underwent robotic segmentectomy. The average age was of 68 years. Most patients had NSCLC (n=34), followed by metastatic disease (n=11) and benign disease (n=4). There was no conversion to laparoscopic or open surgery, or to lobectomy. The median total operative time was 160 minutes, and the median console time, 117 minutes. Postoperative complications occurred in nine patients (18.3%), of whom seven (14.2%) had prolonged hospitalization (>7 days) due to persistent air fistula (n=4; 8.1%) or abdominal complications (n=2.4%). Conclusion: robotic segmentectomy is a safe and viable procedure, offering a short period of hospitalization and low morbidity.
- Creatine supplementation attenuates inflammation in collateral lung after left lung transplantation(2019) ALMEIDA, Francine Maria de; BATTOCHIO, Angela Silva; NAPOLI, Joao Pithon; ALVES, Katiusa Abreu; BALBIN, Grace Susana; OLIVEIRA-JUNIOR, Manoel; MORIYA, Henrique Takachi; PEGO-FERNANDES, Paulo; VIEIRA, Rodolfo Paula; PAZETTI, Rogerio
- The Brazilian Society for Cardiovascular Surgery (SBCCV) and Brazilian Society for Extracorporeal Circulation (SBCEC) Standards and Guidelines for Perfusion Practice(2019) CANEO, Luiz Fernando; MATTE, Gregory; GROOM, Robert; NEIROTTI, Rodolfo A.; PEGO-FERNANDESS, Paulo Manuel; MEJIA, Juan Alberto C.; FIGUEIRA, Fernando Augusto Marinho dos Santos; CARVALHO FILHO, Elio Barreto de; COSTA, Fabio Murilo da; CHALEGRE, Sintya Tertuliano; KALIL, Renato Abdala Karam; ALMEIDA, Rui M. S.
- Transplants in Brazil: where are we?(2019) PEGO-FERNANDES, Paulo Manuel; PESTANA, Jose Osmar Medina; GARCIA, Valter Duro
- Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments(2019) TEDDE, Miguel Lia; TOGORO, Silvia Yukari; EISINGER, Robert Stephen; OKUMURA, Erica Mie; FERNANDES, Angelo; PEGO-FERNANDES, Paulo Manuel; CAMPOS, Jose Ribas Milanez deObjective: Minimally invasive repair of pectus excavatum (MIRPE) is a surgical treatment for PE. During the procedure, a specialized introducer is used to tunnel across the mediastinum for thoracoscopic insertion of a metal bar. There have been reported cases of cardiac perforation during this risky step. The large introducer can be a dangerous lever in unskilled hands. We set out to determine the safety and feasibility of using regular instruments (i.e., not relying on special devices or tools) to create the retrosternal tunnel during MIRPE. Methods: This was a preliminary study of MIRPE with regular instruments (MIRPERI), involving 28 patients with PE. We recorded basic patient demographics, chest measurements, and surgical details, as well as intraoperative and postoperative complications. Results: Patients undergoing MIRPERI had Haller index values ranging from 2.58 to 5.56. No intraoperative complications occurred. Postoperative complications included nausea/vomiting in 8 patients, pruritus in 2, and dizziness in 2, as well as atelectasis, pneumothorax with thoracic drainage, pleural effusion, and dyspnea in 1 patient each. Conclusions: In this preliminary study, the rate of complications associated with MIRPERI was comparable to that reported in the literature for MIRPE. The MIRPERI approach has the potential to improve the safety of PE repair, particularly for surgeons that do not have access to certain special instruments or have not been trained in their use.
- Analysis of Quality of Life after Pleurodesis in Patients with Malignant Pleural Effusion(2019) TERRA, Ricardo Mingarini; COSTA, Priscila Berenice; VEGA, Alberto Jorge Monteiro Dela; ARAUJOB, Pedro Henrique Xavier Nabuco; TEIXEIRA, Lisete Ribeiro; PEGO-FERNANDES, Paulo ManuelBackground: Malignant pleural effusion is one of the most important complications of metastatic cancer, and recurrent pleural effusions do not only have an impact on survival but also cause a huge repercussion on a patient's quality of life. Objectives: The main objective was to describe quality of life status before and after pleurodesis in patients with malignant pleural effusion. Secondary, we aimed to find predictors of quality of life improvement in such a population. Methods: Retrospective analysis of a database collected prospectively. We included patients who underwent pleurodesis from June 2004 to July 2014. Quality of life was evaluated through the WHOQOL-BREF questionnaire and applied before and 30 days after pleurodesis. We used a paired t test and the Wilcoxon rank-sum to compare pre-/post-pleurodesis results, Kaplan-Meier curves for survival analysis, and multiple linear regressions to find predictors of quality of life improvement. Results: 183 patients were included (145 were women). Mean age was 58.3 +/- 12.3 years, the most numerous primary tumor was breast cancer. Median survival time was 9 months. Dyspnea was the most prevalent symptom. Baseline results showed that patients had low quality of life scores. After pleurodesis, there was a significant improvement in respiratory symptoms, physical domain, and general health. Linear regression showed an improvement in physical domain with the sclerosing agent nitrate (p = 0.005). Male gender (p = 0.002) and a higher lymphocyte count (p = 0.01) were inversely associated with improvement in physical domain. Conclusions: Pleurodesis improved symptoms and quality of life in patients with malignant pleural effusion. Gender, lymphocyte count, and sclerosing agent might interfere with quality of life improvement.
- Comparison of Bronchial Anastomotic Techniques in Lung Transplantation by 3D CT Analysis(2019) CIRILLO, G. G.; CHATE, R. C.; NOGUEIRA FILHO, J. M.; DIAS, Y. N.; PEGO-FERNANDES, P. M.; SAMANO, M. N.
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