SERGIO EDUARDO ALONSO ARAUJO
Projetos de Pesquisa
Unidades Organizacionais
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Laparoscopic Total Mesorectal Excision for Rectal Cancer after Neoadjuvant Treatment: Targeting Sphincter-Preserving Surgery(2011) ARAUJO, Sergio Eduardo Alonso; SEID, Victor Edmond; BERTONCINI, Alexandre; CAMPOS, Fabio Guilherme; SOUSA JUNIOR, Afonso; NAHAS, Sergio Carlos; CECCONELLO, IvanBackground/Aims: Laparoscopic total mesorectal excision for rectal cancer is under scrutiny. This study aimed at analyzing feasibility, adequacy of resection, impact on early outcomes after neoadjuvant chemoradiation therapy, and to investigate trend towards indication of laparoscopy for sphincter-preservation in a single university medical center. Methodology: Patients with distal rectal cancer submitted to neoadjuvant treatment followed by laparoscopic total mesorectal excision were prospectively enrolled. The studied parameters were: demographics, previous surgery, BMI, type of operation, rate of sphincter-preserving surgery, duration of surgery, conversion, specimen retrieval, lymphadenectomy, distal and radial margins, intra and postoperative morbidity, reoperations, hospital stay, and mortality. Results: From January 2000 to July 2010, 68 patients were enrolled. Mean age was 60 (30-87) years. There were 27 anterior and 41 abdominoperineal resections. Six patients underwent a totally laparoscopic resection and coloanal anastomosis. There was a trend (p=0.003) towards more sphincter-preserving surgery. Conversion was 4.5%. Intraoperative complication was 7.4%. Postoperative complications occurred in 15%. Mortality was 3%. Lymph-node harvest was 11 (0-33). Mean distal margin was 2.5cm (1-4). Radial margins were positive in 3 (10%) cases. Conclusions: Laparoscopic total mesorectal excision after neoadjuvant treatment is feasible and safe. Sphincter-preserving laparoscopic oncologic rectal surgery has been accomplished more frequently.
- Long-term follow up of abdominal rectosigmoidectomy with posterior end-to-side stapled anastomosis for Chagas megacolon(2011) NAHAS, S. C.; PINTO, R. A.; DIAS, A. R.; NAHAS, C. S. R.; ARAUJO, S. E. A.; MARQUES, C. F. S.; CECCONELLO, I.Aim Chagas' disease is an endemic parasitosis found in Latin America. The disease affects different organs, such as heart, oesophagus, colon and rectum. Megacolon is the most frequent long-term complication, caused by damage to the myoenteric and submucous plexus, ultimately leading to a functional barrier to the faeces. Patients with severe constipation are managed surgically. The study aimed to analyse the 10-year minimum functional outcome after rectosigmoidectomy with posterior end-to-side anastomosis (RPESA). Method A total of 21 of 46 patients were available for follow up. Patients underwent clinical, radiological and manometric evaluation, and the results were compared with preoperative parameters. Results Of the 21 patients evaluated, 81% (17) were female, with a mean age of 60.6 years. Good function was achieved in all patients, with significant improvement in defaecatory frequency (P < 0.0001), usage of enemas (P < 0.0001) and patient satisfaction. Barium enema also showed resolution of the colonic and rectal dilatation in 19 cases evaluated postoperatively. Conclusion Minimal 10-year follow up of RPESA showed excellent functional results, with no recurrence of constipation.
- Surgical Outcomes of Laparoscopic Colorectal Resections for Familial Adenomatous Polyposis(2011) CAMPOS, Fabio Guilherme; ARAUJO, Sergio Eduardo; MELANI, Armando Geraldo; PANDINI, Luis Claudio; NAHAS, Sergio Carlos; CECCONELLO, IvanBackground: Acceptance of extended laparoscopic colon resections is still controversial besides the growing experience over the years. Aim: The aim of this study was to evaluate the postoperative outcomes of laparoscopic colorectal resections exclusively for familial adenomatous polyposis patients. Methods: Patient data, surgical procedures and operative outcomes from 49 patients submitted to total proctocolectomy (TPC) or total abdominal colectomy (TAC) from 1997 to 2009 were prospectively analyzed. Results: There were 18 (36.7%) men and 31 (63.3%) women, with a median age of 31.1 years. Surgical procedures consisted of 3 TPC with ileostomy (6.1%), 30 restorative TPC with ileoanal anastomosis (61.2%), and 16 TAC with ileorectal anastomosis (32.6%). Only 1 patient (2.0%) required open conversion. No patient required blood transfusion. Median operating time was 289, ranging from 150 to 400 minutes. Twelve patients (24.5%) presented complications and only 1 (2.0%) died. Overall complication rates were similar after TAC or TPC (31.2% vs. 21.2%; P = 0.4). Reoperations were necessary in 7 cases (14.3%), and the median length of hospital stay was 6.2 days (3 to 16). The comparison of 2 consecutive groups of patients over time revealed a little improvement in surgery duration (301 to 276 min; P = 0.16), but relevant reduction in morbidity (32% vs. 16.6%; P = 0.2) and reoperation rates (20% vs. 8.3%; P = 0.4), besides the absence of statistical difference. Conclusions: Laparoscopic TPC and TAC represent an interesting alternative approach for young and motivated familial adenomatous polyposis patients. When performed by experienced surgeons, they provide excellent short-term outcome regarding immediate recovery, morbidity, and cosmesis.
- Neoadjuvant chemoradiation therapy followed by curative transanal endoscopic microsurgery (TEM) for rectal cancer complicated by major suture dehiscence: avoiding ileostomy through hyperbaric oxygen therapy(2011) ARAUJO, Sergio Eduardo Alonso; BAMMANN, Roberto Helbert; SEID, Victor Edmond; NAHAS, Sergio Carlos; NAHAS, Caio Sergio Rizkallah; CECCONELLO, Ivan