RICARDO MINGARINI TERRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject IODOPOVIDONE FOR PLEURODESIS IN PATIENTS WITH MALIGNANT PLEURAL EFFUSION: A SAFE OPTION(2013) NETO, Jose D. A.; TERRA, Ricardo M.; VIANNA, Silvana; MAIA, Rodrigo; MARIANI, Alessandro W.; PEGO-FERNANDES, Paulo M.- E-Learning: from useful to indispensable tool(2012) MARIANI, Alessandro Wasum; TERRA, Ricardo Mingarini; PEGO-FERNANDES, Paulo Manuel
conferenceObject WEB-BASED THORACIC SURGERY ONLINE COURSE: INCREASING ACCESS, CONNECTING PEOPLE AND DECREASING INEQUALITIES. FEASIBILITY RESULTS.(2014) TERRA, Ricardo Mingarini; ARAUJO, Pedro Henrique Xavier Nabuco de; MARIANI, Alessandro Wasun; VEGA, Alberto Jorge Monteiro Dela; PEGO-FERNANDES, Paulo- Lung Resection Improves the Quality of Life of Patients With Symptomatic Bronchiectasis(2014) VALLILO, Camilla Carlini; TERRA, Ricardo Mingarini; ALBUQUERQUE, Andre Luis Pereira de; SUESADA, Milena Mako; MARIANI, Alessandro Wasum; SALGE, Joao Marcos; COSTA, Priscila Berenice da; PEGO-FERNANDES, Paulo ManuelBackground. Bronchiectasis is a significant cause of morbidity. Surgical resection is a treatment option, but its main outcomes regarding quality of life (QOL) and physiologic consequences have not been addressed previously, to our knowledge. We aimed to evaluate the effect of surgical procedures on QOL, exercise capacity, and lung function in patients with bronchiectasis in whom medical treatment was unsuccessful. Methods. Patients with noncystic fibrosis in whom medical treatment was unsuccessful and who were candidates for lung resection were enrolled in a prospective study. The main measurements before lung resection and 9 months afterward were QOL according to the Short Form 36 Health Survey and World Health Organization Quality of Life Questionnaires, lung function test results, and the results of maximal cardiopulmonary exercise testing on a cycle ergometer. Results. Of 61 patients who were evaluated, 53 (50.9% male, age 41.3 +/- 12.9 years) underwent surgical resection (83% lobectomies), and 44 completed the 9-month followup. At baseline, they had low QOL scores, mild obstruction, and diminished exercise capacity. After resection, 2 patients died and adverse events occurred in 24.5%. QOL scores improved remarkably at the 9-month measurements, achieving values considered normal for the general population in most dimensions. Functionally, resection caused mild reduction of lung volume; nevertheless, exercise capacity was not decreased. In fact, 52% of the patients improved their exercise performance. Multiple linear regression analysis showed that low QOL before resection was an important predictor of QOL improvement after resection (p = 0.0001). Conclusions. Lung resection promotes a significant improvement in the QOL of patients with noncystic fibrosis bronchiectasis without compromising their exercise capacity. (C) 2014 by The Society of Thoracic Surgeons
- Current morbimortality and one-year survival after pneumonectomy for infectious diseases(2023) D'AMBROSIO, Paula Duarte; MARIANI, Alessandro Wasum; JR, Eserval Rocha; MEDEIROS, Israel Lopes de; OLIVEIRA, Leonardo Cesar Silva; NETO, Antero Gomes; TERRA, Ricardo Mingarini; PEGO-FERNANDES, Paulo ManuelObjective: Identify the one-year survival rate and major complications in patients submitted to pneumonectomy for infectious disease.Methods: Retrospective data from all cases of infectious disease pneumonectomy over the past 10 years were collected from two reference centers. The authors analyzed: patient demographics, etiology, laterality, bronchial stump treatment, presence of previous pulmonary resection, postoperative complications in the first 30 days, the treatment used in pleural complications, and one-year survival rate.Results: 56 procedures were performed. The average age was 44 years, with female predominance (55%). 29 cases were operated on the left side (51%) and the most frequent etiology was post-tuberculosis (51.8%). The overall incidence of complications was 28.6% and the most common was empyema (19.2%). Among empyema cases, 36.3% required pleurostomy, 27.3% required pleuroscopy and 36.3% underwent thoracoplasty for treatment. Bronchial stump fistula was observed in 10.7% of cases. From all cases, 16.1% were completion pneumonectomies and 62.5% of these had some complication, a significantly higher incidence than patients without previous surgery (p = 0.0187). 30-day in-hospital mortality was (7.1%) with 52 cases (92.9%) and 1-year survival. The causes of death were massive postoperative bleeding (1 case) and sepsis (3 cases).Conclusions: Pneumonectomy for benign disease is a high-risk procedure performed for a variety of indications. While morbidity is often significant, once the perioperative risk has passed, the one-year survival rate can be very satisfying in selected patients with benign disease.
- Pleural Fluid Adenosine Deaminase (ADA) Predicts Survival in Patients with Malignant Pleural Effusion(2016) TERRA, Ricardo Mingarini; ANTONANGELO, Leila; MARIANI, Alessandro Wasum; OLIVEIRA, Ricardo Lopes Moraes de; TEIXEIRA, Lisete Ribeiro; PEGO-FERNANDES, Paulo ManuelSystemic and local inflammations have been described as relevant prognostic factors in patients with cancer. However, parameters that stand for immune activity in the pleural space have not been tested as predictors of survival in patients with malignant pleural effusion. The objective of this study was to evaluate pleural lymphocytes and Adenosine Deaminase (ADA) as predictors of survival in patients with recurrent malignant pleural effusion. Retrospective cohort study includes patients who underwent pleurodesis for malignant pleural effusion in a tertiary center. Pleural fluid protein concentration, lactate dehydrogenase, glucose, oncotic cytology, cell count, and ADA were collected before pleurodesis and analyzed. Survival analysis was performed considering pleurodesis as time origin, and death as the event. Backwards stepwise Cox regression was used to find predictors of survival. 156 patients (out of 196 potentially eligible) were included in this study. Most were female (72 %) and breast cancer was the most common underlying malignancy (53 %). Pleural fluid ADA level was stratified as low (< 15 U/L), normal (15 a parts per thousand currency sign ADA < 40), and high (a parts per thousand yen40). Low and high ADA levels were associated with worse survival when compared to normal ADA (logrank: 0.0024). In multivariable analysis, abnormal ADA (< 15 or ADA a parts per thousand yen 40) and underlying malignancies different from lymphoma, lung, or breast cancer were associated with worse survival. Pleural fluid cell count and lymphocytes number and percentage did not correlate with survival. Pleural fluid Adenosine Deaminase levels (< 15 or a parts per thousand yen40 U/L) and neoplasms other than lung, breast, or lymphoma are independent predictors of worse survival in patients with malignant pleural effusion who undergo pleurodesis.
conferenceObject Expected Variability of C-Reactive Protein after Pulmonary Resections: Which Factors Are Associated with Their Normal Variation?(2015) AUGUSTO, Diogo G.; SAMPAIO-FONSECA, Hugo V.; TERRA, Ricardo M.; BIBAS, Benoit J.; LUAMOTO, Leandro R.; ARAUJO, Pedro N.; MARIANI, Alessandro W.; PEGO-FERNANDES, Paulo M.- Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to image guided video assisted thoracoscopic surgery(2016) TERRA, Ricardo Mingarini; ANDRADE, Juliano Ribeiro; MARIANI, Alessandro Wasum; GARCIA, Rodrigo Gobbo; SUCCI, Jose Ernesto; SOARES, Andrey; ZIMMER, Paulo MarceloThe concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases.
conferenceObject QUALITY OF LIFE IN PATIENTS WITH MALIGNANT PLEURAL EFFUSION UNDERGOING PLEURODESI(2013) TERRA, Ricardo M.; MARIANI, Alessandro W.; NETO, Jose D. A.; SUESADA, Milena M.; PEGO-FERNANDES, Paulo M.- Mini-thoracostomy with vacuum-assisted closure: a minimally invasive alternative to open-window thoracostomy(2018) MARIANI, Alessandro Wasum; LISBOA, Joao Bruno Ribeiro Machado; RODRIGUES, Guilherme de Abreu; AVILA, Ester Moraes; TERRA, Ricardo Mingarini; PEGO-FERNANDES, Paulo ManuelThoracostomy is a common treatment option for patients with stage III pleural empyema who do not tolerate pulmonary decortication. However, thoracostomy is considered mutilating because it involves a thoracic stoma, the closure of which can take years or require further surgery. A new, minimally invasive technique that uses the vacuum-assisted closure has been proposed as an alternative to thoracostomy. This study aims to analyze the safety and effectiveness of mini-thoracostomy with vacuum-assisted closure in an initial sample of patients.