PAULO ROGERIO SCORDAMAGLIO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
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- Flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults(2012) RODRIGUES, Ascedio Jose; OLIVEIRA, Eduardo Quintino; SCORDAMAGLIO, Paulo Rogerio; GREGORIO, Marcelo Gervilla; JACOMELLI, Marcia; FIGUEIREDO, Viviane RossiObjective: To determine the success rate of flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults. Methods: This was a retrospective study of all adult patients (over 18 years of age) with foreign body aspiration submitted to bronchoscopy between January of 2009 and January of 2011 at the University of Sao Paulo School of Medicine Hospital das Clinicas, located in Sao Paulo, Brazil. Results: The study sample comprised 40 adult patients, with a mean age of 52 years (range, 18-88 years). The median time of permanence of the foreign body in the airway was 15 days (range, 12 h to 10 years). All of the patients first underwent diagnostic flexible bronchoscopy. Foreign bodies were successfully removed with flexible bronchoscopy in 33 (82.5%) of the patients. In 1 patient, a metal object lodged in the distal bronchial tree required the use of fluoroscopy. Six patients (15%) required rigid bronchoscopy due to tracheal foreign body-induced dyspnea, in 2, and because the foreign body was too large for the flexible forceps, in 4. Bronchoscopy failed in 1 patient, who therefore required surgical bronchotomy. Conclusions: Although rigid bronchoscopy is considered the gold standard for the removal of foreign bodies from the airways, our experience showed that flexible bronchoscopy can be safely and effectively used in the diagnosis and treatment of stable adult patients.
article 13 Citação(ões) na Scopus Minimally invasive bronchoscopic resection of benign tumors of the bronchi(2011) RODRIGUES, Ascedio Jose; COELHO, David; DIAS JUNIOR, Servulo Azevedo; JACOMELLI, Marcia; SCORDAMAGLIO, Paulo Rogerio; FIGUEIREDO, Viviane RossiObjective: Primary benign tumors of the trachea and main bronchi are uncommon. Interventional bronchoscopy allows the diagnosis and the treatment of some of these lesions. Methods: We reviewed four cases endoscopically treated at our institution. Results: Two patients had hamartoma, and two patients had endobronchial lipoma. In all of the cases, the interventional technique for the resection was the use of a polypectomy snare and electrocautery. The only complication reported was one episode of bronchospasm. Conclusions: Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate.- Difficult Airway Intubation with Flexible Bronchoscope(2013) RODRIGUES, Ascedio Jose; SCORDAMAGLIO, Paulo Rogerio; PALOMINO, Addy Mejia; OLIVEIRA, Eduardo Quintino de; JACOMELLI, Marcia; FIGUEIREDO, Viviane RossiBackground and objective: To describe the efficacy and safety of a flexible bronchoscopy intubation (FBI) protocol in patients with difficult airway. Method: We reviewed the medical records of patients diagnosed with difficult airway who underwent flexible bronchoscopy intubation under spontaneous ventilation and sedation with midazolam and fentanyl from March 2009 to December 2010. Results: The study enrolled 102 patients, 69 (67.7%) men and 33 (32.3%) women, with a mean age of 44 years. FBI was performed in 59 patients (57.8%) with expected difficult airway in the operating room, in 39 patients (38.2%) in the Intensive Care Unit (ICU), and in 4 patients (3.9%) in the emergency room. Cough, decrease in transient oxygen saturation, and difficult progression of the cannula through the larynx were the main complications, but these factors did not prevent intubation. Conclusion: FBI according to the conscious sedation protocol with midazolam and fentanyl is effective and safe in the management of patients with difficult airway.
- Flexible broncoscopy in patients in supportive therapy with oxygenation by extracorporeal membrane(2022) REDIVO, Camila Franca; LIMA, Evelise; FERREIRA, Anaregia de Pontes; SCORDAMAGLIO, Paulo Rogerio; CAMPOS, Silvia Vidal; HO, Yeh-Li; RODRIGUES, Ascedio JoseObjective: To report the experience of performing bronchoscopy in patients who underwent supportive therapy with extracorporeal membrane oxygenation in whom the bronchoscopy was performed. Methods: This was a review of medical records of patients diagnosed with extracorporeal membrane oxygenation and who required diagnostic or therapeutic bronchoscopy. Records included were related to patients admitted to the intensive care unit of Hospital das Clinicas of Faculdade de Medicina of Universidade de Sao Paulo, between 2014 and 2020. Results: During the study, 16 bronchoscopies were performed in 8 patients admitted to the intensive care unit and who underwent supportive therapy with extracorporeal membrane oxygenation. The mean age of patients was 28.37 years. Four patients were women (50%). A total of 5 (31.25%) therapeutic bronchoscopies and 11 (68.75%) diagnostics were performed. In 5 of patients, material was collected: 4 samples of bronchoalveolar lavage, three collections of transbronchial biopsies, and 1 of endobronchial biopsies. No patient had radiological worsening or hemodynamic complications. One patient (6.25%) had transient desaturation. There was moderate bleeding after transbronchial biopsy in 1 (6.25%) procedure, which was resolved endoscopically. Conclusion: Patients undergoing extracorporeal membrane oxygenation can safely perform diagnostic or therapeutic bronchoscopy provided that they have a detailed indication. Procedures were performed by a specialized bronchoscopy team in intensive care environment and with the assistance of a qualified multidisciplinary team in membrane oxygenation therapy extracorporeal.
- Can total bronchopleural fistulas from complete stump dehiscence be endoscopically treated?(2017) SCORDAMAGLIO, Paulo Rogerio; TEDDE, Miguel Lia; MINAMOTO, Helio; ASSAD, Renato Samy; FERNANDES, Paulo Manuel PegoOBJECTIVES: Bronchopleural fistula (BPF) is an uncommon complication following a lung resection to address various conditions. BPFs are associated with high morbidity and mortality rates. This study evaluated the endoscopic treatment of 'total' BPFs using the Occlutech-Figulla (R) cardiac device at a single centre. METHODS: We selected nine patients with chronic and complete BPFs. Under direct bronchoscopic visualization, the BPFs were treated using the Occlutech-Figulla device. The patients were followed up for 12 months to determine the treatment level and complications. RESULTS: The procedure had a favourable outcome in three patients, resulting in complete fistula closure. Two patients had partial closure and showed improvements in their clinical conditions. In two other cases, closure of the bronchial stump was unsuccessful using this method. Two patients died from causes unrelated to the procedure or the device. During the follow-up period, no complications related to infection or device-related injuries were reported. CONCLUSIONS: In patients without clinical conditions that require surgical treatment, the Occlutech-Figulla cardiac device can be a safe and effective method for the endoscopic treatment of large BPFs resulting from complete dehiscence of a bronchial stump. No severe events were reported.