MARCELO CRISTIANO ROCHA

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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  • article 6 Citação(ões) na Scopus
    Pop in a scope: attempt to decrease the rate of unnecessary nontherapeutic laparotomies in hemodynamically stable patients with thoracoabdominal penetrating injuries
    (2020) MENEGOZZO, Carlos Augusto M.; DAMOUS, Sergio H. B.; ALVES, Pedro Henrique F.; ROCHA, Marcelo C.; SILVA, Francisco S. Collet e; BARAVIERA, Thiago; WANDERLEY, Mark; SAVERIO, Salomone Di; UTIYAMA, Edivaldo M.
    Background Management of patients with thoracoabdominal penetrating injuries is challenging. Thoracoabdominal penetrating trauma may harbor hollow viscus injuries in both thoracic and abdominal cavities and occult diaphragmatic lesions. While radiological tests show poor diagnostic performance in these situations, evaluation by laparoscopy is highly sensitive and specific. Furthermore, minimally invasive surgery may avoid unnecessary laparotomies, despite concerns regarding complication and missed injury rates. The objective of the present study is to evaluate the diagnostic and therapeutic performance of laparoscopy in stable patients with thoracoabdominal penetrating injuries. Methods Retrospective analysis of hemodynamically stable patients with thoracoabdominal penetrating wounds was managed by laparoscopy. We collected data regarding the profile of the patients, the presence of diaphragmatic injury, perioperative complications, and the conversion rate. Preoperative imaging tests were compared to laparoscopy in terms of diagnostic accuracy. Results Thirty-one patients were included, and 26 (84%) were victims of a stab wound. Mean age was 32 years. Ninety-three percent were male. Diaphragmatic lesions were present in 18 patients (58%), and 13 (42%) had associated injuries. There were no missed injuries and no conversions. Radiography and computerized tomography yielded an accuracy of 52% and 75%, respectively. Conclusion Laparoscopy is a safe diagnostic and therapeutic procedure in stable patients with thoracoabdominal penetrating wound, with low complication rate, and may avoid unnecessary laparotomies. The poor diagnostic performance of preoperative imaging exams supports routine laparoscopic evaluation of the diaphragm to exclude injuries in these patients.
  • article 10 Citação(ões) na Scopus
    Approach to Endoscopic Procedures: A Routine Protocol from a Quaternary University Referral Center Exclusively for Coronavirus Disease 2019 Patients
    (2020) FRANZINI, Tomazo Antonio Prince; KOTINDA, Ana Paula Samy Tanaka; MOURA, Diogo Turiani Hourneaux de; BADANA, Marcia Lopes Vicente; MEDEIROS, Marion Sielfeld de; LIMA, Patricia Goulart Rodrigues; MELLO, Brigitte Feiner de; KAYANO, Rafael Priante; CARMONA, Maria Jose Carvalho; ROCHA, Marcelo Cristiano; CAMPOS, Aleia Faustina; MCCARTY, Thomas R.; GUIMARAES, Thais; MOURA, Maria Luisa do Nascimento; THOMPSON, Christopher C.; MOURA, Eduardo Guimaraes Hourneaux de
    OBJECTIVES: The present coronavirus disease (COVID-19) pandemic has ushered in an unprecedented era of quality control that has necessitated advanced safety precautions and the need to ensure the adequate protection of healthcare professionals (HCPs). Endoscopy units, endoscopists, and other HCP may be at a significant risk for transmission of the virus. Given the immense burden on the healthcare system and surge in the number of patients with COVID-19, well-designed protocols and recommendations are needed. We aimed to systematically characterize our approach to endoscopic procedures in a quaternary university hospital setting and provide summary protocol recommendations. METHOD: This descriptive study details a COVID-19-specific protocol designed to minimize infection risks to patients and healthcare workers in the endoscopy unit. RESULTS: Our institution, located in Sao Paulo, Brazil, includes a 900-bed hospital, with a 200-bed-specific intensive care unit exclusively designed for patients with moderate and severe COVID-19. We highlighted recommendations for infection prevention and control during endoscopic procedures, including appropriate triage and screening, outpatient management and procedural recommendations, role and usage of personal protective equipment (PPE), and role and procedural logistics involving COVID-19-positive patients. We also detailed hospital protocols for reprocessing endoscopes and cleaning rooms and also provided recommendations to minimize severe acute respiratory syndrome coronavirus 2 transmission. CONCLUSION: This COVID-19-specific administrative and clinical protocol can be replicated or adapted in multiple institutions and endoscopy units worldwide. Furthermore, the recommendations and summary protocol may improve patient and HCP safety in these trying times.
  • article 0 Citação(ões) na Scopus
    Transforming operating rooms into intensive care units and the versatility of the physician anesthesiologist during the COVID-19 crisis (vol 75, e2023, 2020)
    (2020) CARMONA, Maria Jose Carvalho; QUINTAO, Vinicius Caldeira; MELO, Brigite Feiner de; ANDRE, Rodrigo Guerson; KAYANO, Rafael Priante; PERONDI, Beatriz; MIETHKE-MORAIS, Anna; ROCHA, Marcelo Cristiano; MALBOUISSON, Luis Marcelo Sa; AULER-JUNIOR, Jose Otavio Costa