FABIO YUJI HONDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
16 resultados
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- A novel approach for the treatment of pelvic abscess: transrectal endoscopic drainage facilitated by transanal endoscopic microsurgery access(2012) MARTINS, B. C.; MARQUES, Carlos Frederico Sparapan; NAHAS, Caio Sergio Rizkallah; HONDO, Fabio Yuji; POLLARA, Wilson; NAHAS, Sergio Carlos; RIBEIRO JUNIOR, U.; CECCONELLO, Ivan; MALUF-FILHO, FauzePostoperative pelvic abscesses in patients submitted to colorectal surgery are challenging. The surgical approach may be too risky, and image-guided drainage often is difficult due to the complex anatomy of the pelvis. This article describes novel access for drainage of a pelvic collection using a minimally invasive natural orifice approach. A 37 year-old man presented with sepsis due to a pelvic abscess during the second postoperative week after a Hartmann procedure due to perforated rectal cancer. Percutaneous drainage was determined by computed tomography to be unsuccessful, and another operation was considered to be hazardous. Because the pelvic fluid was very close to the rectal stump, transrectal drainage was planned. The rectal stump was opened using transanal endoscopic microsurgery (TEM) instruments. The endoscope was advanced through the TEM working channel and the rectal stump opening, accessing the abdominal cavity and pelvic collection. The pelvic collection was endoscopically drained and the local cavity washed with saline through the scope channel. A Foley catheter was placed in the rectal stump. The patient's recovery after the procedure was successful, without the need for further intervention. Transrectal endoscopic drainage may be an option for selected cases of pelvic fluid collection in patients submitted to Hartmann's procedure. The technique allows not only fluid drainage but also visualization of the local cavity, cleavage of multiloculated abscesses, and saline irrigation if necessary. The use of TEM instrumentation allows safe access to the peritoneal cavity.
conferenceObject Endoscopic Papillary Large Balloon Dilation Associated With Sphincterotomy for Extraction of Large Bile Duct Stones(2012) LUZ, Gustavo O.; MOURA, Eduardo G. De; MEINE, Gilmara C.; CARNEIRO, Fred O.; MEDRADO, Bruno F.; ALMEIDA, Maira R.; MALUF-FILHO, Fauze; LERA, Marcos; IDE, Edson; FURUYA, Carlos K.; CHAVES, Dalton M.; CHENG, Spencer; MATUGUMA, Sergio E.; TOMISHIGE, Toshiro; HONDO, Fabio Y.; BARACAT, Renato; ARTIFON, Everson L.; FRANZINI, Tomazo; SAKAI, PauloCommon bile duct stones larger than 15mm are related to a higher rate of failure of endoscopic ductal clearance and need for mechanical lithotripsy. Recently, endoscopic papillary large balloon dilation (EPLBD) associated with endoscopic sphyncterotomy (ES) has been advocated for the management of difficult bile duct stones. Objective: Evaluate the efficacy and safety of EPLBD associated with ES for removal of large bile duct stones. Patients and methods: retrospective review of prospectively collected data in an academic tertiary referral center, from November 2009 to August 2011. Ampullary dilation was performed with a wire guided hydrostatic balloon (CRE/Boston Scientific) which size ranged from 12 to 20mm. The stone size and the duct diameter directed the choice of the balloon diameter. Balloon was inflated with diluted contrast medium under endoscopic and fluoroscopic control until waist disappearance and/or maximal balloon pressure. After dilation stones were extracted with the aid of standard accessories and techniques. Outcomes and adverse events were recorded. Results: A total of 730 patients with common bile duct stones were admitted for ERCP in our institution. 123 (16,8%) patients were submitted to EPLBD after sphincterotomy. The mean age was 56 years (22-98) and 77 were female (63%). The size of the stones ranged from 13 to 30mm. Initial procedure success rate without mechanical lithitripsy was 83% (102/123). In further 4 patients (3,2%) mechanical lithotripsy was used with 75% success rate (3/4). For the remaining 17 patients, mechanical litotripsy was not available and a 10Fr biliary stent was introduced to prevent obstruction and cholangitis. The total adverse events rate was 3,2%. There were 2 cases of perforation with 20mm balloon (1,6%), both treated conservatively, and two cases of mild acute pancreatitis (1,6%). None of the patients presented bleeding that required transfusion or hospitalization. Conclusion: EPLBD after sphincterotomy is a safe and effective technique for the management of large bile duct stones and it avoids mechanical lithotripsy in the majority of cases.- PEG rescue with gastropexy after early tube withdrawal: an application of natural orifice transluminal endoscopic surgery (with video)(2011) MARTINS, Bruno da Costa; TAKADA, Jonas; KAWAGUTI, Fabio Shiguehissa; RIBEIRO, Joao Paulo Aguiar; HONDO, Fabio Yuji; LIMA, Marcelo Simas de; NEVES, Carla Zanellatto; NAHAS, Caio Sergio R.; MARQUES, Carlos Frederico Sparapan; SAKAI, Paulo; MALUF-FILHO, Fauze
- Etiology, endoscopic management and mortality of upper gastrointestinal bleeding in patients with cancer(2013) MALUF-FILHO, Fauze; MARTINS, Bruno da Costa; LIMA, Marcelo Simas de; LEONARDO, Daniel Valdivia; RETES, Felipe Alves; KAWAGUTI, Fabio Shiguehissa; SATO, Cezar Fabiano Manabu; HONDO, Fabio Yuji; SAFATLE-RIBEIRO, Adriana Vaz; RIBEIRO JR., UlyssesBackground: The source and outcomes of upper gastrointestinal bleeding (UGIB) in oncologic patients are poorly investigated. Objective: The study aimed to investigate these issues in a tertiary academic referral center specialized in cancer treatment. Methods: This was a retrospective study including all patients with cancer referred to endoscopy due to UGIB in 2010. Results: UGIB was confirmed in 147 (of 324 patients) referred to endoscopy for a suspected episode of GI bleeding. Tumor was the most common cause of bleeding (N = 35, 23.8%), followed by varices (N = 30, 19.7%), peptic ulcer (N = 29, 16.3%) and gastroduodenal erosions (N = 16, 10.9%). Among the 32 patients with cancer of the upper GI tract, the main causes of bleeding were cancer (N = 27, 84.4%) and peptic ulcer (N = 5, 6.3%). Forty-one patients (27.9%) presented with bleeding from the primary tumor or from a metastatic lesion, and seven received endoscopic therapy, with successful initial hemostasis in six (85.7%). Rebleeding and mortality rates were not different between endoscopically treated (N = 7) and nontreated (N = 34) patients (28.6% vs. 14.7%, p = 0.342; 43.9% vs. 44.1%, p = 0.677). Median survival was 20 days, and the overall 30-day mortality rate was 44.9%. There was no predictive factor of mortality or rebleeding. Conclusion: Tumor bleeding is the most common cause of UGIB in cancer patients. UGIB in cancer patients correlates with a high mortality rate regardless of the bleeding source. Current endoscopic treatments may not be effective in preventing rebleeding or improving survival.
bookPart Colangite aguda(2014) BARACAT, Renato; JúNIOR, Carlos Kiyoshi Furuya; HONDO, Fabio Yuji; ARTIFON, Everson Luiz de Almeida- OCULAR MELANOMA WITH MULTIPLE GASTROINTESTINAL METASTASES(2011) KAWAGUTI, Fabio Shiguehissa; MALUF-FILHO, Fauze; MEDEIROS, Raphael Salles S.; MARTINS, Bruno Da Costa; LIMA, Marcelo Simas De; HONDO, Fabio Yuji; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; SAKAI, Paulo
- A new large-caliber trocar for percutaneous endoscopic gastrostomy by the introducer technique in head and neck cancer patients(2011) GIORDANO-NAPPI, J. H.; MALUF-FILHO, F.; ISHIOKA, S.; HONDO, F. Y.; MATUGUMA, S. E.; LIMA, M. Simas de; SANTOS, M. Lera dos; RETES, F. A.; SAKAI, P.Background and study aims In many patients, percutaneous endoscopic gastrostomy (PEG) can be limited by digestive tract stenosis. PEG placement using an introducer is the safest alternative for this group of patients, but the available devices are difficult to implement and require smaller-caliber tubes. The aim of this study was to evaluate the modification of an introducer technique device for PEG placement with regard to the following: procedure feasibility, possibility of using a 20-Fr balloon gastrostomy tube, tube-related function and problems, complications, procedure safety, and mortality. Patients and methods Between March 2007 and February 2008, 30 consecutive patients with head and neck malignancies underwent introducer PEG placement with the modified device and gastropexy. Each patient was evaluated for 60 days after the procedure for the success of the procedure, infection, pain, complications, mortality, and problems with the procedure. Results The procedure was successful in all cases with no perioperative complications. No signs of stomal infection were observed using the combined infection score. The majority of patients experienced mild-to-moderate pain both in the immediate postoperative period and at 72 hours. One major early complication (3.3%) and two minor complications (6.7%) were observed. No procedure-related deaths occurred during the first 60 days after the procedure. Conclusion The device modification for PEG using the introducer technique is feasible, safe, and efficient in outpatients with obstructive head and neck cancer. In this series, it allowed the use of a larger-caliber tube with low complication rates and no procedure-related mortality.
bookPart Divertículos esofágicos e faringoesofágicos(2013) UEMURA, Ricardo Sato; HONDO, Fábio Yuji; SAKAI, Paulo- Comparison of electrical current and ultrasonic device for incision of the septum of the pharyngoesophageal diverticulum in a pig model(2015) HONDO, Fabio Yuji; GIORDANO-NAPPI, Jose Humberto; PESSORRUSSO, Fernanda Cristina Simoes; FRANCO, Matheus Cavalcante; NEVES, Carla Zanelatto; CECCONELLO, Ivan; SAKAI, Paulo; MALUF-FILHO, FauzeComplications of endoscopic treatment of pharyngoesophageal diverticulum (PED) such as bleeding and perforation occur in up to 15 % of cases. Our objective was to compare incision of the PED septum using the ultrasonic device (group H) with incision using electrical current (group M) in a pig model. Twenty domestic pigs were divided into groups H and M. The incision of the PED septum was performed using the ultrasonic device or using electrical current, respectively. The procedural time, complication rate, length of the border of the incised septum, and thermal tissue damage were compared between groups. Mean time to divide the septum and total procedure time were significantly shorter in group H. Mean length of the border of the incised septum was significantly higher in group H. The lateral thermal spread caused by electrical current (group M) was more intense. Hemorrhage was exclusively observed in group M. Experimental endoscopic diverticulotomy using ultrasonic device was faster and caused less tissue damage when compared to electrical current.
- Endoscopic removal of migrated esophageal stent - the ""grasper and pusher"" method(2012) MARTINS, B.; SORBELLO, M. P.; RETES, F.; KAWAGUTI, F. S.; LIMA, M. S.; HONDO, F. Y.; STELKO, G.; RIBEIRO, U.; MALUF-FILHO, F.