MARIANNY NAZARETH SULBARAN NAVA

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  • article 0 Citação(ões) na Scopus
    Endoscopic colostomy with percutaneous colopexy: an animal feasibility study
    (2017) BUSTAMANTE-LOPEZ, Leonardo Alfonso; SULBARAN, Marianny; NAHAS, Sergio Carlos; MOURA, Eduardo Guimaraes Horneaux de; NAHAS, Caio Sergio; MARQUES, Carlos Federico; SAKAI, Christiano; CECONELLO, Ivan; SAKAI, Paulo
    Background: Indications for colostomy in colorectal diseases are obstruction of the large bowel, such as in cancer, diverticular disease in the acute phase, post-radiotherapy enteritis, complex perirectal fistulas, anorectal trauma and severe anal incontinence. Some critically ill patients cannot tolerate an exploratory laparotomy, and laparoscopic assisted colostomy also requires general anesthesia. Objective: To evaluate the feasibility, safety and efficacy of performing colostomy assisted by colonoscopy and percutaneous colopexy. Materials and methods: Five pigs underwent endoscopic assisted colostomy with percutaneous colopexy. Animals were evaluated in post-operative days 1, 2, 5 and 7 for feeding acceptance and colostomy characteristics. On day 7 full colonoscopy was performed on animals followed by exploratory laparotomy. Results: Average procedure time was 27 minutes (2154 min). Postoperative mobility and feeding of animals were immediate after anesthesia recovery. Position of the colostomy, edges color, appearance of periostomal area, as well as its function was satisfactory in four animals. Retraction of colostomy was present in one pig. The colonoscopy and laparotomy control on the seventh day were considered as normal. A bladder perforation that was successfully repaired through the colostomy incision occurred in one pig. The main limitation of this study is its experimental nature. Conclusion: Endoscopic assisted colostomy with percutaneous colopexy proves to be a safe and effective method with low morbidity for performing colostomy in experimental animals, with possible clinical application in humans.
  • article
    Duodenal adenoma surveillance in patients with familial adenomatous polyposis
    (2015) CAMPOS, Fabio Guilherme; SULBARAN, Marianny; SAFATLE-RIBEIRO, Adriana Vaz; MARTINEZ, Carlos Augusto Real
    Familial adenomatous polyposis (FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patient's age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion (1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP.
  • article 6 Citação(ões) na Scopus
    A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter
    (2016) BUSTAMANTE-LOPEZ, L.; SULBARAN, M.; SAKAI, C.; MOURA, E. G. de; BUSTAMANTE-PEREZ, L.; NAHAS, C. S.; NAHAS, S. C.; CECCONELLO, I.; SAKAI, P.
    Introduction and aims: Rectal prolapse is common in the elderly, having an incidence of 1% in patients over 65 years of age. The aim of this study was to evaluate the safety and feasibility of a new endoluminal procedure for attaching the previously mobilized rectum to the anterior abdominal wall using an endoscopic fixation device. Materials and methods: The study is a single-arm phase I experimental trial. Under general anesthesia, total rectal prolapse was surgically reproduced in five pigs. Transanal endoscopic reduction of the rectal prolapse was performed. The best site for transillumination of the abdominal wall, suitable for rectopexy, was identified. The EndoLifter was used to approximate the anterior wall of the proximal rectum to the anterior abdominal wall. Two percutaneous rectopexies were performed by puncture with the Loop Fixture II Gastropexy Kit at the preset site of transillumination. After the percutaneous rectopexies, rectoscopy and exploratory laparotomy were performed. Finally, the animals were euthanized. Results: The mean procedure time was 16 min (11-21) and the mean length of the mobilized specimen was 4.32 cm (range 2.9-5.65cm). A total of 10 fixations were performed with a technical success rate of 100%. There was no evidence of postoperative rectal prolapse in any of the animals. The EndoLifter facilitated the process by allowing the mucosa to be held and manipulated during the repair. Conclusions: Endoscopic-assisted percutaneous rectopexy is a safe and feasible endoluminal procedure for fixation of the rectum to the anterior abdominal wall in experimental animals. (C) 2016 Asociacion Mexicana de Gastroenterologia.