MIGUEL LIA TEDDE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
Instituto do Coração, 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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- A new technique for T-tube insertion in patients with subglottic stenosis(2011) TEDDE, Miguel Lia; RODRIGUES, Ascedio; SCORDAMAGLIO, Paulo Rogerio; MONTEIRO, Jackellyne SantosA silicone T tube is widely used for the management of airway problems. Montgomery described the way in which it is usually inserted, but this conventional insertion technique can fail in cases of subglottic stenosis due to the softness of the T tube, which kinks when forced against resistance. An adjunct to the traditional technique of Montgomery may help to insert a T tube in such patients.
- The Nuss procedure made safer: an effective and simple sternal elevation manoeuvre(2012) TEDDE, Miguel L.; CAMPOS, Jose Ribas Milanez de; WIHLM, Jean-Marie; JATENE, Fabio BiscegleThe Nuss procedure requires the creation of a substernal tunnel for bar positioning. This is a manoeuvre that can be dangerous, and cardiac perforation has occurred in a few cases. Our purpose was to describe two technical modifications that enable the prevention of these fatal complications. A series of 25 patients with pectus excavatum were treated with a modification of the Nuss procedure that included the entrance in the left haemithorax first, and the use of the retractor to lift the sternum, with the consequent lowering displacement of the heart. These modified techniques have certain advantages: (i) the narrow anterior mediastinum between the sternum and the pericardial sac is expanded by pulling up the sternum; (ii) the thoracoscopic visualization of the tip of the introducer during tunnel creation is improved; (iii) the rubbing of the introducer against the pericardium is minimized; (iv) the exit path of the introducer can be guided by the surgeon's finger and (v) haemostasis and integrity of the pericardial sac can be more easily confirmed. We observed that with these manoeuvres, the risk of pericardial sac and cardiac injury can be markedly reduced.
- Analysis of the Results of Videotoracoscopic Sympathectomy in the Treatment of Hyperhidrosis in Patients 40 Years or Older(2020) FAUSTINO, Carolina B.; CAMPOS, Jose Ribas Milanez de; KAUFFMAN, Paulo; LEIDERMAN, Dafne Diamante; TEDDE, Miguel; CUCATO, Gabriel; FERNANDES, Paulo P.; LEAO, Pedro P.; WOLOSKER, NelsonBackground: Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (video-assisted thoracoscopic sympathectomy [VATS]) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of patients aged 40 years or older compared with those of young adult patients (19-40 years). Methods: We retrospectively analyzed 2,431 HH patients who underwent bilateral VATS and divided the patients into the following groups: a group younger than 40 years old (1,760 patients) and a group 40 years and older (142 patients). Variables included quality of life before surgery, improvement in quality of life after surgery, clinical improvement in sweating, the presence of severe compensatory hyperhidrosis (CH), and general satisfaction at 1 month after surgery. Results: We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the 2 groups of patients. More than 90% of the patients in this series had great clinical improvement in the main HH site, with no significant difference between the 2 groups. Severe CH occurred in 23.8% of the patients in this series, with no significant difference between the 2 groups. Conclusions: Patients 40 years of age or older benefit just as much as younger patients from VATS performed to treat primary HH, presenting excellent significant surgical results.
bookPart Pectus carinatum: tratamento cirúrgico e/ou tratamento não invasivo?(2023) TEDDE, Miguel Lia; CAMPOS, José Ribas Milanez; SAVAZZI, Flavio Henrique; SOUSA, Vanessa Moreira- To cross or not to cross pectus bars: is this already a dilemma?(2022) TEDDE, Miguel Lia
- Letter to the Editor(2021) TEDDE, Miguel L.
- Bronchoscopic closure of tracheoesophageal fistulas(2011) RODRIGUES, Ascedio Jose; SCORDAMAGLIO, Paulo Rogerio; TEDDE, Miguel Lia; MINAMOTO, Helio; MOURA, Eduardo Guimaraes Hourneaux de; PEDRA, Carlos A. C.
- Correspondence on Should the Ravitch Procedure to Correct Pectus Excavatum Be Avoided in Young Children?(2022) TEDDE, M. L.; BEER, S. A. de; PARK, H. J.To the editor: In addition to the excellent outcome they obtained, the case reported by Rim and Park [1] shows the boldness and inventiveness of the authors: boldness for performing the fourth surgical procedure (previously, the patient had undergone the Ravitch procedure, correction with 2 metal bars, and removal of the bars) for the repair of recurrent pectus excavatum (PE), and inventiveness for proposing a 3-dimensional-printed artificial thoracic wall, which as far as we know is an unprecedented treatment, to correct this serious defect © 2022. The Korean Society for Thoracic and Cardiovascular Surgery
- Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments(2019) TEDDE, Miguel Lia; TOGORO, Silvia Yukari; EISINGER, Robert Stephen; OKUMURA, Erica Mie; FERNANDES, Angelo; PEGO-FERNANDES, Paulo Manuel; CAMPOS, Jose Ribas Milanez deObjective: Minimally invasive repair of pectus excavatum (MIRPE) is a surgical treatment for PE. During the procedure, a specialized introducer is used to tunnel across the mediastinum for thoracoscopic insertion of a metal bar. There have been reported cases of cardiac perforation during this risky step. The large introducer can be a dangerous lever in unskilled hands. We set out to determine the safety and feasibility of using regular instruments (i.e., not relying on special devices or tools) to create the retrosternal tunnel during MIRPE. Methods: This was a preliminary study of MIRPE with regular instruments (MIRPERI), involving 28 patients with PE. We recorded basic patient demographics, chest measurements, and surgical details, as well as intraoperative and postoperative complications. Results: Patients undergoing MIRPERI had Haller index values ranging from 2.58 to 5.56. No intraoperative complications occurred. Postoperative complications included nausea/vomiting in 8 patients, pruritus in 2, and dizziness in 2, as well as atelectasis, pneumothorax with thoracic drainage, pleural effusion, and dyspnea in 1 patient each. Conclusions: In this preliminary study, the rate of complications associated with MIRPERI was comparable to that reported in the literature for MIRPE. The MIRPERI approach has the potential to improve the safety of PE repair, particularly for surgeons that do not have access to certain special instruments or have not been trained in their use.
bookPart Fixação dos arcos costais e do esterno no trauma torácico(2023) CAMPOS, José Ribas Milanez; MARIANI, Alessandro Wasum; TEDDE, Miguel Lia; LAURICELLA, Leticia Leone