CARLOS ALFREDO BATAGELLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
19 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 19
- One week pre-operative oral antibiotics for percutaneous nephrolithotomy reduce risk of infection: a systematic review and meta-analysis(2023) DANILOVIC, Alexandre; TALIZIN, Thalita Bento; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni S.; BATAGELLO, Carlos; VICENTINI, Fabio C.; NAHAS, Willaim C.; MAZZUCCHI, EduardoPurpose: The aim of this meta-analysis is to assess the efficacy of extended dose of preoperative antibiotics to reduce infectious risk in patients undergoing percutaneous nephrolithotomy (PCNL).Materials and Methods: A literature search for prospective case-control studies or randomized controlled trials was done. PICO framework was used.Population: adult patients that underwent to PCNL; Intervention: extended dose preoperative antibiotic prophylaxis before PCNL; Control: short dose preoperative antibiotic prophylaxis befo-re PCNL; and Outcome: systemic inflammatory response syndrome (SIRS) or sepsis, fe-ver after PCNL and positive intraoperative urine and stone culture. This meta-analysis was registered in PROSPERO database under the number: CRD42022359589.Results: Three RCT and two prospective studies (475 patients) were included. SIRS/ sepsis outcome was retrieved from all studies included. Seven days preoperative oral antibiotics for PCNL was a protective factor for developing SIRS/sepsis (OR 0.366, 95% CI 0.234 -0.527, p < 0.001). There was no statistical association between seven-day use of antibiotics and fever (OR 0.592, 95% CI 0.147 - 2.388, p = 0.462). Patients who received seven days preoperative antibiotics had lower positive intraoperative urine culture (OR 0.284, 95% CI 0.120 - 0.674, p = 0.004) and stone culture (OR 0.351, 95% CI 0.185 - 0.663, p = 0.001) than the control group.Conclusion: one week of prophylactic oral antibiotics based on local bacterial sensi-tivity pattern plus a dose of intravenous antibiotics at the time of surgery in patients undergoing PCNL reduces the risk of infection.
- Size is Not Everything That Matters: Preoperative CT Predictors of Stone Free After RIRS(2019) DANILOVIC, Alexandre; ROCHA, Bruno Aragao; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni Scala; BATAGELLO, Carlos; VICENTINI, Fabio Carvalho; TRAXER, Olivier; VIANA, Publio Cesar Cavalcante; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoOBJECTIVE To define computed tomography (CT) predictors of residual fragments after retrograde intrarenal surgery (RIRS) for kidney stones up to 20 mm in patients never submitted to surgical procedures for stone removal. METHODS From August 2016 to August 2017, symptomatic adult patients with kidney stones less than 20 mm treated by RIRS had their pre- and postoperative CT prospectively evaluated in search for predictors of residual stone fragments. Stone size, stone volume, number of stones, stone density, and location were evaluated in preoperative CT and analyzed as predictors for residual stone fragments on 90 POD CT. Stone location was represented by the infundibulopelvic angle (IPA) measured for each stone on preoperative noncontrast CI using multiplanar reconstruction. RESULTS Ninety-two patients were successfully submitted to RIRS. Bilateral procedures were performed in 23 patients (25%) resulting in 115 renal units operated. Operative time was 54.5 +/- 26.7 minutes (mean +/- SD) and 96.7% (89/92) of the patients were discharged up to 12 hours after the procedure. Postoperative CI demonstrated stone-free in 86 of 115 (74.8%), 0-2 mm in 10 of 115 (8.7%), and > 2 mm residual fragments in 19 of 115 (16.5%) procedures. Logistic regression analysis revealed steep IPA was a predictor for any residual stone fragment after RIRS for kidney stones < 20 mm (P= .012). ROC curve showed that IPA < 41 degrees was associated with a higher chance of residual fragments after RIRS. CONCLUSION IPA < 41 degrees is associated with a higher chance of residual fragments after RIRS for kidney stones up to 20 mm. (C) 2019 Elsevier Inc.
conferenceObject IN VITRO EVALUATION OF SINGLE-USE DIGITAL FLEXIBLE URETEROSCOPES: A PRACTICAL COMPARISON FOR A PATIENT-CENTERED APPROACH(2018) MARCHINI, Giovanni; BATAGELLO, Carlos; MONGA, Manoj; TORRICELLI, Fabio; VICENTINI, Fabio; DANILOVIC, Alexandre; SROUGI, Miguel; NAHAS, William; MAZZUCCHI, EduardoconferenceObject PROSPECTIVE EVALUATION OF BILATERAL RIRS: IS IT REALLY SAFE?(2020) DANILOVIC, Alexandre; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; TRAXER, Olivier; SROUGI, Miguel; NAHAS, William; MAZZUCCHI, EduardoconferenceObject IS SUPINE PERCUTANEOUS NEPHROLITHOTOMY FOR COMPLEX STONES WORSE THAN PRONE? A MULTICENTER RANDOMIZED CONTROLLED TRIAL.(2021) PERRELLA, Rodrigo; VICENTINI, Fabio; PARO, Eliane; MARCHINI, Giovani; TORRICELLI, Fabio; DANILOVIC, Alexandre; BATAGELLO, Carlos; MOTA, Priscila Kuriki; BELTRAME, Daniel; COHEN, David; MURTA, Claudio; CLARO, Joaquim; NAHAS, William; SROUGI, Miguel; MAZZUCCHI, EduardoconferenceObject POSTOPERATIVE ANTIBIOTIC PROPHYLAXIS FOR PERCUTANEOUS NEPHROLITHOTOMY AND RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) TALIZIN, Thalita; DANILOVIC, Alexandre; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; NAHAS, William; MAZZUCCHI, Eduardo- Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery(2021) DANILOVIC, Alexandre; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni Scala; BATAGELLO, Carlos; VICENTINI, Fabio Carvalho; TRAXER, Olivier; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoBackground: Despite technology incorporation to percutaneous nephrolithotomy (PCNL), residual stone fragments (RSFs) may still persist after PCNL and need to be addressed to avoid regrowth or ureteral obstruction. The objective of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) to extracorporeal shockwave lithotripsy (SWL) for treating patients with RSFs after a previous standard PCNL. Materials and Methods: Adult patients with RSF after a standard PCNL submitted to RIRS or SWL in our Institution from January 2017 to January 2020 were retrospectively studied. Stone-free rate (SFR) was evaluated on postoperative day (POD) 90 by noncontrast CT (NCCT) or ultrasound and kidney, ureter, and bladder radiograph (KUB) for each renal unit. Surgical complications based on Clavien-Dindo classification during the 90 days of follow-up were recorded. Sample size was calculated for a power of 80% and a significance level of 0.05, assuming SFR of 20% for SWL and 50% for RIRS. Results: Thirty-three patients treated by SWL were compared with 36 patients treated by RIRS. Hospitalization time was longer in the RIRS group (4.18 vs 12.33 hours, p = 0.001). SFR and success rate were lower in SWL than RIRS group (24.2% vs 58.3%, p = 0.007 and 30.3% vs 72.2%, p = 0.004, respectively), using POD 90 NCCT in 81.8% and ultrasound and KUB in 18.2% of the SWL group and using POD 90 NCCT in 100% of the RIRS group. Minor complications (Clavien-Dindo < III) occurred in 11 of 36 (30.6%) patients submitted to RIRS and in 2 of 33 (6.1%) patients submitted to SWL group (p = 0.025). Two patients (6.1%) of the SWL group had Clavien-Dindo IIIb complication owing to Steinstrasse and were submitted to ureteroscopy. Emergency room visits were similar between groups (6.1% vs 8.3%, p = 1.0). Conclusions: RIRS has better SFR, higher minor complications, and lower major complications than SWL for the treatment of RSFs after standard PCNL.
- Effect of a low-calorie diet on 24-hour urinary parameters of obese adults with idiopathic calcium oxalate kidney stones(2021) DANILOVIC, Alexandre; MARCHINI, Giovanni Scala; PUCCI, Nidia Denise; COIMBRA, Brian; TORRICELLI, Fabio Cesar Miranda; BATAGELLO, Carlos; VICENTINI, Fabio Carvalho; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoPurpose: to evaluate the effect of low-calorie diet on 24-hour urinary metabolic parameters of obese adults with idiopathic calcium oxalate kidney stones. Materials and Methods: Adult idiopathic calcium oxalate stone formers, with body mass index (BMI) >= 30kg/m(2) and a known lithogenic metabolic abnormality, were submitted to low-calorie diet for twelve weeks. After enrolment, anthropometric measures, serum exams, 24-hour urinary metabolic parameters and body impedance were collected one month prior to dietary intervention and at the end of twelve weeks. Correlations between weight loss, waist circumference loss, fat loss and variation in 24-hour urinary lithogenic parameters and calcium oxalate urinary supersaturation (CaOx SS) as per Tiselius equation were analysed. Results: From January 2017 to January 2018, 39 patients were enrolled to participate in this study. Median (range) prescribed diet was 1300 (1100-2100) Kcal/day. Mean age was 51.7 +/- 11.0 (29-68) years old and 69.2% were female. 30.8% of the participants shifted from obesity to BMI <30kg/m(2) and none to BMI <25kg/m(2). A significant correlation was found between baseline 24-hour urinary oxalate and weight (p=0.018) and BMI (p=0.026). No correlation was found between variation of weight, waist circumference, fat mass and 24-h urinary stone risk factors or CaOx SS. Conclusions: Short-term modest weight loss induced by twelve weeks of low-calorie diet is not associated with a decrease of 24-hour urinary lithogenic parameters in idiopathic calcium oxalate stone formers. Calcium oxalate urinary stone formation is probably multifactorial and driven by other factors than weight.
conferenceObject IMPACT OF THE PATIENT POSITION ON COMPLICATION RATES OF PERCUTANEOUS NEPHROLITHOTOMY FOR COMPLEX STONES: A RANDOMIZED STUDY(2020) PERRELLA, Rodrigo; VICENTINI, Fabio C.; PARO, Eliane D.; MARCHINI, Giovani S.; TORRICELLI, Fabio C. M.; DANILOVIC, Alexandre; BATAGELLO, Carlos; MURTA, Claudio B.; CLARO, Joaquim F. A.; NAHAS, Willian; MAZZUCCHI, EduardoconferenceObject ONE WEEK PREOPERATIVE ORAL ANTIBIOTICS FOR PERCUTANEOUS NEPHROLITHOTOMY REDUCE RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) DANILOVIC, Alexandre; TALIZIN, Thalita; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; NAHAS, William; MAZZUCCHI, Eduardo