FABIO CARVALHO VICENTINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
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- 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.
- International Alliance of Urolithiasis guideline on retrograde intrarenal surgery(2023) ZENG, Guohua; TRAXER, Olivier; ZHONG, Wen; OSTHER, Palle; PEARLE, Margaret S.; PREMINGER, Glenn M.; MAZZON, Giorgio; SEITZ, Christian; GEAVLETE, Petrisor; FIORI, Cristian; GHANI, Khurshid R.; CHEW, Ben H.; GIT, Kah Ann; VICENTINI, Fabio Carvalho; PAPATSORIS, Athanasios; BREHMER, Marianne; MARTINEZ, Juan Lopez; CHENG, Jiwen; CHENG, Fan; GAO, Xiaofeng; GADZHIEV, Nariman; PIETROPAOLO, Amelia; PROIETTI, Silvia; YE, Zhangqun; SARICA, KemalObjectives To set out the second in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis that concerns retrograde intrarenal surgery (RIRS), with the aim of providing a clinical framework for urologists performing RIRS. Materials and Methods After a comprehensive search of RIRS-related literature published between 1 January 1964 and 1 October 2021 from the PubMed database, systematic review and assessment were performed to inform a series of recommendations, which were graded using modified GRADE methodology. Additionally, quality of evidence was classified using a modification of the Oxford Centre for Evidence-Based Medicine Levels of Evidence system. Finally, related comments were provided. Results A total of 36 recommendations were developed and graded that covered the following topics: indications and contraindications; preoperative imaging; preoperative ureteric stenting; preoperative medications; peri-operative antibiotics; management of antithrombotic therapy; anaesthesia; patient positioning; equipment; lithotripsy; exit strategy; and complications. Conclusion The series of recommendations regarding RIRS, along with the related commentary and supporting documentation, offered here should help provide safe and effective performance of RIRS.
conferenceObject 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, 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- Comparison of the outcomes of flexible ureteroscopy and mini-percutaneous nephrolithotomy for the treatment of kidney stones: a matched-pair analysis(2022) RODRIGUES, Jose Eduardo Castro Matheus; VICENTINI, Fabio Carvalho; DANILOVIC, Alexandre; MARCHINI, Giovanni Scala; TORRICELLI, Fabio Cesar Miranda; BATAGELLO, Carlos Alfredo; MAZZUCCHI, Eduardo; NAHAS, William CarlosOBJECTIVE: Mini-percutaneous nephrolithotomy is a recent advancement in the field of kidney stone treatment; however, its role has not been completely established. We aimed to compare the outcomes of initial Mini-percutaneous nephrolithotomy and flexible ureteroscopy.METHODS: A retrospective review of consecutive mini-percutaneous procedures was performed. Inclusion criteria were as follows: all percutaneous nephrolithotomy procedures performed with an access sheath up to 24Fr, kidney stone burdens up to 1550 mm3; and the presence of postoperative computed tomography (for control). The data collected for Mini-percutaneous nephrolithotomy procedures were paired 1:2 with patients treated with flexible ureteroscopy for stones between 100 and 1550 mm3, and with postoperative computed tomography for control. A 14Fr Mini-percutaneous nephrolithotomy set was used. The stone-free rate was defined as the absence of fragments on the control computed tomography, whereas success was limited to 2-mm residual fragments. Statistical analysis was performed using SPSS version 19.RESULTS: A total of 63 patients met the inclusion criteria (42 with flexible ureteroscopy and 21 with mini-percutaneous nephrolithotomy). Demographic data were comparable. The stone-free rate and success were similar between the groups (76.2 vs. 66.7%, p=0.42 and 90.5 vs. 85.7%, p=0.57). The complication rate was also similar (26.1 vs. 9.6%, p=0.188), but Mini-percutaneous nephrolithotomy had longer hospitalization and fluoroscopy time (p=0.001 in both).CONCLUSIONS: Our initial study of Mini-percutaneous nephrolithotomy showed that it is a promising procedure, with outcomes similar to flexible ureteroscopy, but with higher inpatient numbers and fluoroscopy times. A larger study population size and better equipment may improve the outcomes of mini-percutaneous nephrolithotomy.