JOSE PINHATA OTOCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
DVCLCIR-62, Hospital Universitário
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
DVCLCIR-62, Hospital Universitário
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
10 resultados
Resultados de Busca
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article 1 Citação(ões) na Scopus EUS-Guided access to dorsal pancreatic duct in a patient with pancreas divisum(2012) ARTIFON, Everson L. A.; FRAZÃO, Mariana S. V.; COELHO FERREIRA, Flávio; PINHATA OTOCH, JoséCase report of pancreas divisum dorsal pancreatic duct access with endoscopic ultrasonography help to relief pain in a patient with not possible access by PCREarticle 1 Citação(ões) na Scopus Local staging of rectal carcinoma: Systematic review of literature and meta-analysis(2016) GUENAGA, Katia F; OTOCH, Jose P; ARTIFON, Everson L. ANew surgical techniques in the treatment of rectal cancer have improved survival mainly by reducing local recurrences. A preoperative staging method is required to accurately identify tumor stage and planning the appropriate treatment. MRI and ERUS are currently being used for the local staging (T stage). In this review, the accuracy of MRI and ERUS with rigid probe was compared against the gold standard of the pathological findings in the resection specimens. Five studies met the inclusion criteria and were included in this meta-analysis. The accuracy was 91.0% to ERUS and 86.8% to MRI (p=0.27). The result has no statistical significance but with pronounced heterogeneity between the included trials as well as other published reviews. We can conclude that there is a clear need for good quality, larger scale and prospective studiesarticle Divertículo de Meckel perforado(2017) GATTO, Janaina; TAKADA, Jonas; OTOCH, Jose P.; KREVE, ernanda; LOSS, Francisco S.; ARTIFON, Everson L. A.We report a patient with diffuse peritonitis due to perforation of Meckel's diverticulum. This patient was referred to the operating room and underwent bowel resection segment encompassing the area of the diverticulum and terminoterminal primary enteroanastomosis on two levels with good evolution. The diverticulum complications are often related to the presence of ectopic mucosa, especially the gastric and pancreatic type. Since preoperative diagnosis is difficult and infrequent, in most cases this anomaly is confirmed only during surgery. Surgical resection of the affected intestinal segment is the mainstay of treatment in both diverticula diagnosed incidentally, as the complicated by inflammation, bleeding, obstruction or perforation. We conclude that in cases of acute abdomen punctured, the diagnosis of Meckel's diverticulum should be considered.article 8 Citação(ões) na Scopus Surgical or endoscopic management for post-ERCP large transmural duodenal perforations: a randomized prospective trial(2015) ARTIFON, Everson L. A; K. MINATA, Mauricio; B. CUNHA, Marco Antonio; P. OTOCH, Jose; P. APARICIO, Dayse; K. FURUYA, Carlos; B. PAIONE, José L.Introduction: Duodenal perforations are an uncommon adverse event during ERCP. Patients can develop significant morbidity and mortality. Even though surgery has been used to manage duodenal complications, therapeutic endoscopy has seen significant advances. Objective: To compare endoscopic approach with surgical intervention in patients with duodenal perforations post-ERCP. Material and Methods: prospective randomized study in a tertiary center with 23 patients divided in 2 groups. Within 12 hours after the event, the patients underwent endoscopic or surgical approach. Endoscopic approach included closure of the perforation with endoclips and SEMS. Surgical repair included hepaticojejunostomy, suture of the perforation or duodenal suture. The success was defined as closure of the defect. Secondary outcomes included mortality, adverse events, days of hospitalization and costs. Results: The success was 100% in both groups. There was one death in the endoscopic group secondary to sepsis. There was no statistical difference in mortality or adverse events. We noticed statistical difference in favor of the endoscopic group considering shorter hospitalization (4.1 days versus 15.2 days, with p=0.0123) and lower cost per patient (U$14,700 versus U$19,872, with p=0.0103). Conclusions: Endoscopic approach with SEMS and endoclips is an alternative to surgery in large transmural duodenal perforations post-ERCParticle Systematic review and meta-analysis of endoscopic ablative treatment of Barrett’s esophagus(2014) FERREIRA DE SOUZA, Thiago; DE ALMEIDA ARTIFON, Everson Luiz; MAZZONETTO MESTIERI, Luiz Henrique; MANSUR REIMÃO, Sílvia; TOYAMA AIRES, Felipe; MARQUES BERNARDO, Wanderley; PINHATA OTOCH, Jose; HOURNEAUX DE MOURA, Eduardo GuimarãesBackground: Barrett’s esophagus (BE) is the main risk factor for esophageal adenocarcinoma. Its therapeutic approach is controversial and surgical treatment in the presence of high-grade intraepithelial neoplasia may be indicated. Endoscopic approach is an alternative with lower mortality and morbidity rates and favorable results. Objective: To define the best option, according to literature, to treat Barrett’s Esophagus. Materials and methods: Design: Systematic review of PUBMED, EMBASE, LILACS, and Cochrane Library databases was conducted and articles of randomized, controlled studies on BE endoscopic ablative treatment were selected. The systematic review through PUBMED retrieved results with higher evidence level and available recommendation grade regarding BE ablative therapy. Nine articles on randomized, controlled studies classified as A or B according to the Oxford table were selected. Cryotherapy, laser, photodynamic therapy (PDT), multipolar electrocoagulation (MPEC), and ablation through argon plasma coagulation (APC) and radiofrequency were considered ablation therapies. Patients: 649 patients from 10 different studies were analysed. Results: PDT was found to present an increase in treatment failure compared with APC, NNH = -7. BE ablation through MPEC or APC was found to have similar risk for treatment failure in meta-analysis. PDT associated with proton pump inhibitor (PPI) is beneficial for BE ablation regarding PPI use alone, NNT = 2. Radiofrequency with PPI is an efficient method to reduce risk of treatment failure, NNT = 1. Conclusions: There are no studies demonstrating the benefit of indicating cryotherapy or laser therapy for BE endoscopic approach. APC ablation was found to have superior efficacy compared with PDT and ablation through APC and MPEC was found to present effective, similar results. Radiofrequency is the most recent approach requiring comparative studies for indication.article 0 Citação(ões) na Scopus A novel endoscopic treatment of pancreas divisum(2012) ARTIFON, Everson L. A.; FRAZÃO, Mariana S. V.; COELHO FERREIRA, Flávio; PINHATA OTOCH, JoséPancreas divisum is the most common congenital malformation of the pancreas that results from the non-fusion or incomplete fusion of the ventral and dorsal portions of the embryonic pancreas. It is found in 7% of autopsy studies (range 1-14%) and is generally asymptomatic. 5% of the patients have symptoms, which are basically cases of abdominal pain and recurrent pancreatitis. We report the case of a woman of 51y, postcholecystectomy with 2 episodes of pancreatitis with imaging from magnetic resonance of pancreatic divisum with communication between the dorsal and ventral pancreas. We proceeded by endoscopy (ERCP) to dilate the major duct, and then made a minor duct papillotomy and made a hydropneumatic ball dilatation with the catheter balloon up the waist portion. The procedure was successful with 9 months of follow up.article 0 Citação(ões) na Scopus Recurrent acute pancreatitis caused by pancreatic biliary maljunction due to long common channel(2016) FARIAS, Galileu F. A.; OTOCH, Jose P.; GUEDES, Hugo G.; ARTIFON, Everson L. A.The pancreatic biliary maljunction is a rare anomaly that affects mainly females, defined as an anatomical maljunction of the pancreatic duct and the biliary duct confluence, and may be a rare cause of recurrent acute pancreatitis. In order to early diagnosis and prompt treatment, ERCP has an important role in itarticle 1 Citação(ões) na Scopus Difficult cannulation: what should I do before EUS guided access?(2014) ARTIFON, Everson L.A; MOURA, Renata N; OTOCH, Jose PSelective cannulation of the common bile duct can be difficult, so multiple strategies have been developed to overcome the situation. In this review we analize the different strategies that can be used like different papillotome instead of the standard catheter, precut papillotomy using precut needle knives or precut papillotome, transpancreatic papillary septotomy, and stenting of the pancreatic duct. Bile duct cannulation remains an important benchmark of successful ERCP. Alternative biliary access indication and its use is very important If biliary cannulation remains unsuccessful.The suprapapillary puncture is a promissory technique. It´s important to have in mind that the goal of all techniques is to provide acute pancreatitis decreasearticle 12 Citação(ões) na Scopus Endoscopic-ultrasound versus percutaneous-guided celiac plexus block for chronic pancreatitis pain: A systematic review and meta-analysis(2015) NOBRE MOURA, Renata; HOURNEAUX DE MOURA, Eduardo Guimarães; MARQUES BERNARDO, Wanderley; OTOCH, Jose P; CASTILLO BUSTAMANTE, Fabio Alberto; VIEIRA ALBERS, Débora; RODELA SILVA, Gustavo Luis; MARQUES CHAVES, Dalton; DE ALMEIDA ARTIFON, Everson LuizBackground: Abdominal pain is present in the vast majority of patients with chronic pancreatitis, being frequently debilitating. Celiac plexus block (CPB) is an interventional technique that can be considered to provide a temporary pain relief. Objective: To estimate the effectiveness and safeness of endoscopic-ultrasound (EUS) comparing with percutaneous-guided CBP in patients with pancreatic pain. Methods: A systematic review of English and non-English articles using MEDLINE, EMBASE, LILACS and COCHRANE (via BVS). Study selection and data extraction: Only randomized control trials (RCT) comparing the beneficial and harmful effects of EUS and percutaneous-guided celiac plexus block for managing pancreatic pain were included. Data was extracted and analyzed on variables including pain relief and related procedure complications. Results: Two RCT met the inclusion criteria. Both studies assessed the primary outcome (reduction on pain score) and evaluated adverse effects. The drugs injected were the same; nevertheless percutaneous technique was guided by fluoroscopy in one study and by computer tomography (CT) in other. The results showed that the EUS-CPB group was more effective to reduce pain score after 4 weeks after the procedure, with risk of bias to do this affirmation. No statistical difference in pain relief at 1, 8 and 12 weeks and in complications rates. Conclusions: Based on this systematic review and meta-analysis, no statistically significant difference was noted in pain relief and complications for EUS and percutaneous - CPB.article 4 Citação(ões) na Scopus Ex Vivos Models to Teaching Therapeutic Endoscopic Ultrasound (T-EUS)(2018) L.A. ARTIFON, Everson; CHENG, Spencer; NAKADOMARI, Thaisa; KASHIWAGI, Leandro; ARDENGH, Jose Celso; BELMONTE, Emilio; P. OTOCH, JoseBackground: Endoscopic ultrasound training has a learning curve greater than the other endoscopic therapeutic techniques. One of the preclinical teaching methods is the use of ex vivo porcine models. Aim: To describe five ex vivo porcine models for training in therapeutic echoendoscopic procedures. Materials and methods: Using porcine digestive tract containing esophagus, stomach, duodenum, spleen, liver and gallbladder, five models for therapeutic echoendoscopy training were described. With other segments of the porcine pieces (such as the bladder, spleen segment and omentum segment) and with easily accessible materials (such as grape and ultrasound gel), lesions were simulated to be treated. These models were applied in the Hands on course at the IRCAD (Institut de recherche contre les cancers de l'appareil digestif) Barretos of 2017. Endoscopic equipment and instruments are the same as those used in clinical practice. Result: The models are easily reproducible and do not require exchange during the hands on course period. Endoscopic and echographic imaging and tactile sensitivity are similar to the real one. Conclusion: The models described in this study demonstrated to be realistic, easy to reproduce and allow repetition during the same session. However, comparative studies are necessary to verify the real impact on teaching