FABIO CARVALHO VICENTINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
13 resultados
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- 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.
- Differences in the percutaneous nephrolithotomy practice patterns among Latin American urologists with and without endourology training(2018) MANZO, Braulio O.; LOZADA, Edgar; VICENTINI, Fabio C.; SANCHEZ, Francisco Javier; MANZO, GildardoPurpose: Although the worldwide percutaneous nephrolithotomy (PCNL) practice patterns determined via a survey sent to members of the Endourological Society have been published, differences in PCNL practice patterns among Latin American urologists based on endourological or lithiasis training have not been published. To determine the PCNL practice patterns among Latin American urologists with and without training in endourology. Materials and Methods: The SurveyMonkeys (R) web platform was used to develop a 27-item survey on PCNL for the treatment of renal stones, and the survey was sent via e-mail and other electronic media to 2000 urologists from 15 Latin American countries. Endourology-trained (group 1) and nontrained urologists (group 2) were analyzed. The group results were compared using the chi-squared and Fisher's exact tests. SPSS version 20 for Windows was used for all analyses. Results: A total of 331 urologists responded to the survey (rate of 16.55 %): 221 (66.7 %) in group 1 and 110 (33.2%) in group 2). In groups 1 and 2, 91.9% and 63.2% performed PCNL, respectively; 85.1% and 58.5% used preoperative tomography, respectively; 12.7% and 4.7% used preoperative nephrolitometry nomograms, respectively; 45.2% and 32.1% used endoscopic combined intrarenal surgery, respectively; 68.3% and 38.7% used multiple percutaneous tract realization, respectively; and 19.9% and 5.7% used minimally invasive PCNL, respectively (all p=0.0005). Conclusions: Statistically significant differences were observed in PCNL practice patterns of Latin American urologists with and without training in endourology. Specific training in endourology significantly influence the practice patterns of Latin American urologists.
article 3 Citação(ões) na Scopus Endoscopic guided PCNL in the prone split-leg position versus supine PCNL: a comparative analysis stratified by Guy's stone score(2019) BATAGELLO, Carlos A.; SANTOS, Hugo D. Barone dos; NGUYEN, Andrew H.; ALSHARA, Luay; LI, Jianbo; MARCHINI, Giovanni Scala; VICENTINI, Fabio C.; TORRICELLI, Fabio Cesar Miranda; DANILOVIC, Alexandre; PEREIRA, Jessica Goulart; ROSE, Emily; SROUGI, Miguel; NAHAS, Willian C.; MAZZUCCHI, Eduardo; MONGA, ManojIntroduction: The optimal patient positioning for percutaneous nephrolithotomy (PCNL) based on the complexity of stone burden is not yet defined. Thus, we aimed to evaluate the intraoperative parameters, effectiveness and complications of patients undergoing PCNL between the endoscopic-guided prone split-leg PCNL (ePSL) and the supine PCNL by stratifying patients according to Guy's stone score (GSS). Materials and methods: A retrospective chart review was conducted of patients undergoing PCNL at two high-volume tertiary referral centers. At one center, patients underwent PCNL using the ePSL technique, while at the second center, patients underwent PCNL in supine. Patient demographics and stone characteristics, operative details, complications and effectiveness were compared between groups. The impact of obesity was also investigated. Results: Of 830 subjects, a total of 449 (54%) underwent PCNL in ePSL and 381 (46%) in supine. The ePSL group had a greater mean age and body mass index. No statistical differences were found in gender, serum chemistry and Charlson comorbidity index. After stratifying patients by GSS, the differences in baseline stone burden between PSL and supine lost significance and both groups could be compared. Complications were not statistically different between both groups. Univariate analysis demonstrated that multiple tracts and lower pole access were more prevalent in supine. In addition, for GSS1-3, ePSL was correlated with reduced operative time, radiation exposure, length of hospital stay and need for secondary procedure. Multivariate analysis correlated ePSL with lower radiation exposure and need for secondary procedures (p = 0.01). In comparison to the whole trial population, the same tendencies were appreciated for obese cohort. Conclusions: This is the first report focusing on the performance differences between ePSL and supine PCNL stratified by GSS. Both techniques are safe, with a low rate of complications. For GSS1-3, ePSL reduces radiation exposure and requires less need for both multiple access and secondary procedure.article 1 Citação(ões) na Scopus Supine percutaneous nephrolitotripsy in septuagenarian and octogenarian patients: outcomes of a case-control study(2018) TORRICELLI, Fabio C. M.; OGAWA, Guilherme K. M.; VICENTINI, Fabio C.; MARCHINI, Giovanni S.; DANILOVIC, Alexandre; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoIntroduction: Currently, there is a paucity of data evaluating the outcomes of supine percutaneous nephrolithotomy (PCNL) in septuagenarian and octogenarian patients. In this study we aim to compare the outcomes of supine PCNL in elderly patients with those of younger population. Material and methods: A matched case-control study was performed from January 2009 through December 2015 using our prospectively collected kidney stone database. Case group was composed of patients with age greater than 70 years. Control group included patients with less than 70 years old. Patients were randomly matched based on Guy's Stone Score as a surrogate of case complexity. Results: Fifty-four patients were enrolled in this study, 18 cases and 36 controls. There were no significant differences in gender and body mass index between groups. There were significantly more ASA 3 patients in septuagenarian and octogenarian patients (p = 0.012). Mean Charlson comorbidity index was significantly higher in septuagenarian and octogenarian patients (p = 0.041). Regarding PCNL technique, there were no differences in number of accesses, number of supra-costal accesses, and operative time. There was no significant difference in stone free rate, nephrostomy tube time, complication rate, mean decrease in hemoglobin level, and need of blood transfusion. Hospital stay time (days) was longer in case group (4.0 +/- 1.7 versus 2.4 +/- 1.1 days; p = 0.002). Conclusion: Septuagenarian and octogenarian patients have similar complication and stone-free rates compared to younger patients, although they demand a longer length of hospital stay.- In Vitro Evaluation of Single-Use Digital Flexible Ureteroscopes: A Practical Comparison for a Patient-Centered Approach(2018) MARCHINI, Giovanni Scala; BATAGELLO, Carlos A.; MONGA, Manoj; TORRICELLI, Fabio Cesar Miranda; VICENTINI, Fabio C.; DANILOVIC, Alexandre; SROUGI, Miguel; NAHAS, Willian C.; MAZZUCCHI, EduardoObjective: To compare the manufacturing and in vitro performance characteristics of two single-use flexible ureteroscopes with a permanent optical flexible ureteroscope. Materials and Methods: Two single-use flexible ureteroscopes, LithoVue (Boston Scientific) and Pusen (1rs. generation; Zhuhai Pusen Medical Technology Company Limited, China), were tested and compared with a permanent Flex-X-2 ureteroscope (Karl Storz, Germany) in terms of technical characteristics, optics, deflection mechanism, and additional parameters which could potentially affect surgical technique. Results: Pusen was the lightest ureteroscope while the LithoVue had the longest working length. LithoVue had a higher resolution power than the other two ureteroscopes at all distances tested (p<0.001). Pusen showed higher resolution than Flex-X-2 (p<0.01). Field of view was wider for LithoVue (87 degrees), followed by Flex-X-2 (85 degrees) and Pusen (75 degrees). Color representation was superior for Flex-X-2 than LithoVue and then Pusen. LithoVue outperformed Pusen and Flex-X-2 for all settings with instruments in terms of deflection loss (p<0.01). Pusen had the highest irrigation flow (52mL/min) with an empty working channel (p<0.01). LithoVue and Pusen showed similar flow rates with a 200m (21mL/min) and 365m laser fiber (7mL/min) and 1.3F basket (18mL/min), being superior to Flex-X-2 (p<0.01). With the 1.9F basket, LithoVue had superior flow rate (7mL/min) than Pusen (3.5mL/min) and Flex-X-2 (4mL/min; p=0.01). Conclusion: LithoVue outperformed the other ureteroscopes in terms of optical resolution, field of view, deflection capacity, and irrigation flow with larger instruments. Pusen is the lighter scope and showed better results in terms of irrigation when no instruments are in place. Flex-X-2 was superior in terms of color representation.
- Silent Ureteral Stones: Impact on Kidney Function-Can Treatment of Silent Ureteral Stones Preserve Kidney Function?(2012) MARCHINI, Giovanni S.; VICENTINI, Fabio C.; MAZZUCCHI, Eduardo; BRITO, Arthur; EBAID, Gustavo; SROUGI, MiguelOBJECTIVE To report our experience with silent ureteral stones and expose their true influence on renal function. METHODS We analyzed 506 patients who had undergone ureterolithotripsy from January 2005 to May 2010. Silent ureteral stones were calculi found in the absence of any specific or subjective ureteral stone-related symptoms. Of the 506 patients, 27 (5.3%) met these criteria (global cohort). All patients were assessed postoperatively with dimercaptosuccinic acid scintigraphy (DMSA). A difference in relative kidney function of >10% was considered abnormal. Pre- and postoperative comparative DMSA analyses were electively obtained for 9 patients (kidney function cohort). A t test was used to assess the numeric variables, and the chi-square test or Fisher's exact test was used for categorical variables. Two-tailed P < .05 was considered statistically significant. RESULTS Stones were diagnosed by radiologic abdominal evaluation for nonurologic diseases in 40% and after previous nephrolithiasis treatment in 33%. The primary therapy was ureterolithotripsy in 88%. The mean follow-up time was 23 months. The overall ureteral stone-free rate after 1 and 2 procedures was 96% and 100%, respectively. In the global cohort, the mean pre- and postoperative serum creatinine levels were similar (P = .39), and the mean postoperative function on DMSA was 31%. In the kidney function cohort, no difference was found between the pre-and postoperative DMSA findings (22% +/- 12.1% vs 20% +/- 11.8%; P = .83) and serum creatinine (0.8 +/- 0.13 mg/dL vs 1.0 +/- 0.21 mg/dL; P = .45). CONCLUSION Silent ureteral stones are associated with decreased kidney function present at the diagnosis. Hydronephrosis tends to diminish after stone removal, and kidney function remains unaltered. UROLOGY 79: 304-309, 2012. (C) 2012 Elsevier Inc.
- 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.
article 5 Citação(ões) na Scopus Supracostal punctures in supine percutaneous nephrolithotomy are safe(2017) WOOD, Guilherme J. A.; TORRICELLI, Fabio C. M.; VICENTINI, Fabio C.; SROUGI, Miguel; MAZZUCCHI, EduardoIntroduction: The feasibility and safety of supracostal punctures in supine percutaneous nephrolithotomy (PCNL) are still controversial. In this study we aim to compare success and complication rates from prone and supine PCNL with at least one supracostal puncture. Material and methods: We reviewed our electronic database for all supracostal PCNLs performed in our institution from February 2008 to September 2013. Patients were enrolled in the study if at least one supracostal puncture was required during surgery. Patients' demographics data, stone characteristics, intra and postoperative data, and success on first postoperative day CT were compared. Results: A total of 132 procedures were included in the analysis. Twenty-eight PCNLs were performed in supine position (21.2%), while 104 were done in prone position (78.8%). Patient's demographics and distribution of stones based on Guy's Score were similar between groups. Mean operative time and blood transfusion rate were not statistically different. There was no significant difference in the success rate (63.5% prone versus 71.4% supine, p = 0.507). Major complication rate (Clavien >= 3) was 16.3% in the prone group versus 3.6% in the supine group (p = 0.119). Conclusions: Supracostal punctures are safe and feasible in supine PCNL. It does not add additional risks and might provide equivalent success rates when compared to prone PCNLs.- Renal manifestations of sarcoidosis: from accurate diagnosis to specific treatment(2020) CORREIA, Filipe A. Saliba C.; MARCHINI, Giovanni S.; TORRICELLI, Fabio C.; DANILOVIC, Alexandre; VICENTINI, Fabio C.; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoSarcoidosis is a multisystem granulomatous disease characterized by epithelioid non-caseating granulomas associated with clinical and radiologic findings. The cause of this disease is still uncertain. Sarcoidosis affects mostly lungs and lymph nodes and is not usually considered a urological disease, therefore, this etiology may be overlooked in several urological disorders, such as hypercalcemia, hypercalciuria and nephrolithiasis. It affects all races and genders. This review aims to describe the urological manifestations of sarcoidosis and to elucidate how the disease may affect the management of numerous urological conditions.