FABIO YOSHIAKI TANNO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- The Use of Three-dimensional Printers for Partial Adrenalectomy: Estimating the Resection Limits(2016) SROUGI, Victor; ROCHA, Bruno A.; TANNO, Fabio Y.; ALMEIDA, Madson Q.; BARONI, Ronaldo H.; MENDONA, Berenice B.; SROUGI, Miguel; FRAGOSO, Maria C.; CHAMBO, Jose L.OBJECTIVE To avoid hormonal replacement after partial adrenalectomy (PA), establishing the precise limit of an adrenal gland resection is essential. Herein, we evaluated the use of three-dimensional (3D) adrenal gland printing and volumetry measurement before PA to improve the determination of the remnant gland volume. METHODS Concomitant total adrenalectomy and a contralateral PA were performed in a patient with primary macronodular adrenal hyperplasia that exhibited mild hypercortisolism, arterial hypertension, and diabetes. Before surgery, a 3D replica of the adrenal gland to be partially resected was printed and given to the surgeon. The volumetry of the gland was measured by computed tomography 3D image reconstruction. RESULTS No postoperative complications were noted. Immediately after the surgery, the patient initiated corticosteroid replacement, which was interrupted 52 days later. At the 6-month follow-up, the patient stopped using medications for diabetes and reduced the number of antihypertensive medications from 5 to 1. The pre- and postoperative serum cortisol levels were, respectively, 28 and 8.7 mcg/dl (n 5-25 mcg/dl). The pre-and postoperative adrenocorticotropic hormone levels were, respectively, <5 and 88 pg/ml (n 7.2-63 pg/ml). The postoperative adrenal volume was 12% of the total preoperative adrenal volume. CONCLUSION The use of 3D printing associated with adrenal volumetry might be a useful tool for the surgeon when performing PA, enabling an estimation of the remnant gland volume. (C) 2016 Elsevier Inc.
- Presentation and surgery outcomes in elderly with pheocromocytoma: a comparative analysis with young patients(2016) SROUGI, Victor; CHAMBO, Jose L.; TANNO, Fabio Y.; SOARES, Iracy S.; ALMEIDA, Madson Q.; PEREIRA, Maria A. A.; SROUGI, Miguel; FRAGOSO, Maria C.Purpose: To evaluate the presentation and early surgical outcomes of elderly patients undergoing adrenalectomy for phaeochromocytoma. Patients and Methods: A retrospective search was performed of our adrenal disorders database for patients who underwent surgery for phaeochromocytoma or paraganglioma between 2009 and 2014. Patients > 60 years old were classified as elderly. The clinical manifestations, intraoperative course, and early postoperative outcomes of elderly patients were compared to those of younger individuals (< 60 years old). Results: The mean (+/- standard deviation) age in the older (n= 10) and younger (n= 36) groups was 69.6 +/- 5.3 years and 34.0 +/- 12.9 years. Germ-line mutations were more common in younger patients (50.0% versus 0%; p=0.004), whereas incidental lesions were more common in the elderly (40.0% versus 5.3%; p=0.003). In both groups, surgery was most commonly performed by videolaparoscopy (90% in the elderly and 82% in the younger group), with similar intraoperative anesthetic and surgical outcomes. Post-operatively, the older group more commonly received vasoactive drugs (60.0% versus 10.5%; p<0.001) and had a longer intensive care unit stay (3.1 +/- 2.8 versus 1.4 +/- 1.0 days; p= 0.014), more clinical complications (60% versus 18.9%; p= 0.01), and longer hospital stay (10.2 +/- 8.4 versus 5.7 +/- 4.9 days; p= 0.028). Conclusions: Although all patients received the same preoperative preparation, the elderly group exhibited a slower and more complicated recovery after adrenalectomy. Meticulous perioperative care should be used in the elderly when treating phaeochromocytoma; nevertheless, adrenalectomy is a relatively safe procedure in this patient population.
conferenceObject A META-ANALYSIS OF THE ROLE OF ADJUVANT RADIOTHERAPY AFTER SURGERY FOR ADRENOCORTICAL CARCINOMA(2016) SROUGI, Victor; BESSA, Jose; TANNO, Fabio; FERREIRA, Amanda; LOUSADA, Lia; ALMEIDA, Madson; ALMEDA, Cristiane; SROUGI, Miguel; MENDONCA, Berenice; HOFF, Ana; CHAMBO, Jose; FRAGOSO, Maria