ALEXANDRE SILVA E SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
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conferenceObject In Bag Morcellation: details and logistics of the technique(2016) FERNANDES, R.; ARAUJO, M.; SILVA, A. Silva e; CARVALHO, P. Mancusi de; ANTON, C.; GENTA, M. L. Nogueira Dias; RIBEIRO JR., A. Dias; SAMPAIO, D.; MIGLINO, G.; SADALLA, J. C.; CARVALHO, J. PaulaconferenceObject VAGINAL-ASSISTED LAPAROSCOPIC RADICAL HYSTERECTOMY (VALRH): INITIAL EXPERIENCE OF A GYNECOLOGICAL CANCER CENTER IN BRAZIL(2013) FAVERO, G.; SILVA, A. Silva e; ANTON, C.; RIBEIRO, A.; ARAUJO, M. Pereira; SADALLA, J.; MIGLINO, G.; BARACAT, E.; CARVALHO, J.- BORDERLINE OVARIAN TUMORS-10 YEARS SINGLE CENTER EXPERIENCE(2019) FERNANDES, R.; ANTON, C.; SILVA, A. Silva e; CARVALHO, J. P. Mancusi; ARAUJO, M.; GENTA, M. L. Dias; SAMPAIO, D.; MIGLINO, G.; DIAS JR., A.; SADALLA, J. C.; CARVALHO, J. Paula
conferenceObject VAGINAL MORCELLATION INSIDE PROTECTIVE POUCH AND UTERINE EXTRATION IN CASES OF BULKY ENDOMETRIAL CANCERS: REPORT OF 30 CASES(2015) FAVERO, G.; MIGLINO, G.; KOEHLER, C.; PFIFFER, T.; SILVA, A.; RIBEIRO, A.; DOGAN, N. U.; ANTON, C.; BARACAT, E.; CARVALHO, J.conferenceObject NEW APPROACH TO DEFINE PATIENTS WITH LOW RISK LYMPH NODE METASTASIS WITH ENDOMETRIAL CANCER(2015) ANTON, C.; FAVERO, G. M.; SILVA, A. S.; MANCUSI, J. P.; ARAUJO, M. P.; SUAREZ, G. M.; GENTA, M. L. D.; PIATO, D. S. A. M.; DIAS JR., A. R.; FERNANDES, R. P.; SADALLA, J. C.; CARVALHO, J. P.conferenceObject CORRECTION OF IATROGENIC INJURY OF THE OBTURATOR NERVE BY THE USE OF SURAL NERVE GRAFTS(2013) DIAS, A. Ribeiro; SILVA, A. Silva e; MIGLINO, G.; MARTINS, R. S.; CARDOSO, M. A. Capel; BALBINO, R.; CARDOSO, A. Bigelli; BARACAT, E. Chada; FAVERO, G.conferenceObject Borderline Ovarian Tumors: 15 year experience from a Single institute(2016) FERNANDES, R.; ANTON, C.; SILVA, A. Silva e; ARAUJO, M.; SAMPAIO, D.; MIGLINO, G.; CARVALHO, J. P. Mancusi de; RIBEIRO JR., A. Dias; SADALLA, J. C.; GENTA, M. L. Nogueira Dias; CARVALHO, J. Paula- Vaginal Morcellation Inside Protective Pouch: A Safe Strategy for Uterine Extration in Cases of Bulky Endometrial Cancers:. Operative and Oncological Safety of the Method(2015) FAVERO, Giovanni; MIGLINO, Giovanni; KOEHLER, Christhardt; PFIFFER, Tatiana; SILVA, Alexandre Silva e; RIBEIRO, Altamiro; LE, Xin; ANTON, Cristina; BARACAT, Edmund Chada; CARVALHO, Jesus PaulaObjective: To evaluate the operative and oncologic outcomes of an innovative technique for organ morcellation in patients scheduled for laparoscopic treatment of uterine malignancies. ] Background: Endoscopy is currently considered the standard of care for the operative treatment of endometrial cancer; however, the use of minimal invasive surgery (MIS) is restricted in patients with a bulky uterus or narrow vagina. Conventional unprotected intraperitoneal uterine fragmentation is indeed contraindicated in these cases. Consequently, oncologically safe methods to render these patients eligible for MIS are urgently needed. Intervention: Prospective study of women with histologically proven endometrial cancer in which uterus removal was a realistic concern owing to both organ size and proportionality. The patients underwent laparoscopic staging, including retroperitoneal lymphadenectomy, total hysterectomy, and bilateral salpingo-oophorectomy, followed by vaginal morcellation of the uterus inside a protective pouch (LapSac). Results: In our series of 30 cases, we achieved successful completion in all patients, without conversion to laparotomy. No surgery-related casualty or intraoperative morbidity was observed. The mean organ size was 246 g (range, 148-420 g), and the average additional operative time related to vaginal morcellation was 16 minutes (range, 9-28 minutes). Proper histopathological staging according to 2009 FIGO staging guidelines could be performed in all specimens. Two patients (6%) presented with significant postoperative complications, 1 each with vesicovaginal fistula and vaginal vault dehiscence. Fourteen patients (46%) needed adjuvant therapy. After a median follow-up of 20 months (range, 6-38 months), the 12-month and 24-month overall survival was 100% and 73.4% (95% confidence interval, 51%-96%), respectively. Four patients with positive lymph nodes died of distant metastasis. No case of pelvic or local relapse was observed. Conclusion: Vaginal morcellation following oncologic principles is a feasible method that permits rapid uterine extraction and potentially avoids unnecessary laparotomies. This series suggests that the technique may be oncologically safe and also can be used in cases of uterine pathology of uncertain malignancy.
- Vaginal morcellation: A new strategy for large gynecological malignant tumor extraction A pilot study(2012) FAVERO, Giovanni; ANTON, Cristina; SILVA, Alexandre Silva e; RIBEIRO, Altamiro; ARAUJO, Marcia Pereira; MIGLINO, Giovanni; BARACAT, Edmund Chada; CARVALHO, Jesus PaulaObjective. Evaluate feasibility and safety of a novel technique for uterine morcellation in patients scheduled for laparoscopic treatment of gynecologic malignances. Background. The laparoscopic management of uterine malignancies is progressively gaining importance and popularity over laparotomy. Nevertheless, minimal invasive surgery is of limited use when patients have enlarged uterus or narrow vagina. In these cases, conventional uterus morcellation could be a solution but should not be recommended due to risks of tumor dissemination. Methods. Prospective pilot study of women with endometrial cancer in which uterus removal was a realistic concern due to both organ size and proportionality. Brief technique description: after completion of total laparoscopic hysterectomy and bilateral anexectomy, a nylon with polyurethane Lapsac (R) is vaginally inserted into the abdomen; the specimen is placed inside the pouch that will be closed and rotated 180 degrees toward the vaginal vault and, posteriorly, pushed into the vaginal canal; in the transvaginal phase, the surgeon pulls the edges of the bag up to vaginal introitus and all vaginal walls will be covered; inside the pouch, the operator performs a uterus bisection-morcellation. Results. In our series of 8 cases, we achieved successful completion in all patients, without conversion to laparotomy. Average operative time, blood loss and length of hospitalization were favorable. One patient presented with a vesicovaginal fistula. Conclusion. The vaginal morcellation following oncologic principles is a feasible method that permits a rapid uterine extraction and may avoid a number of unnecessary laparotomies. Further studies are needed to confirm the oncological safety of the technique.