BENOIT JACQUES BIBAS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Hemangioma of the Rib(2011) ABRAO, Fernando Conrado; TAMAGNO, Mauro; CANZIAN, Mauro; FERNANDEZ, Angelo; BIBAS, Jacques; FERNANDES, Paulo Manuel Pego; JATENE, Fabio BiscegliAn asymptomatic 48-year-old woman presented to our hospital with a tumor of the rib incidentally diagnosed on a chest roentgenogram. The patient was investigated and underwent tumor resection of the chest wall. The pathologic study revealed that it was cavernous hemangioma. This tumor of the bone is a distinctly uncommon benign vascular tumor, generally occurring in the spine or skull. Hemangiomas involving the rib are even more rare, with only 22 cases described in the literature. However, we suggest that this tumor of the rib should be considered in the differential diagnosis, principally in asymptomatic patients. (Ann Thorac Surg 2011;91:595-6) (C) 2011 by The Society of Thoracic Surgeons
- Impact of fundoplication for gastroesophageal reflux in the outcome of benign tracheal stenosis(2019) BIANCHI, Edno Tales; CARDOSO, Paulo Francisco Guerreiro; MINAMOTO, Helio; BIBAS, Benoit Jacques; SALATI, Michele; PEGO-FERNANDES, Paulo ManuelObjective: This study focuses on the impact of antireflux surgery in the outcome of tracheal stenosis. Methods: We performed a retrospective study including patients with benign tracheal stenosis who underwent esophageal manometry and dual-probe 24-hour ambulatory esophageal pH study. Patients with an abnormal pH study were managed with laparoscopic modified Nissen fundoplication or medically (omeprazole 80 mg/d, orally). Patients with normal pH study results were observed. After a 24-month follow-up, the outcome was considered satisfactory if tracheal stenosis could be managed by resection and there was no need for further dilatation or definitive decannulation. The management groups were compared using propensity score matching. Results: A total of 175 patients were included. Abnormal pH study results were found in 74 patients (42.3%), and 12.6% of patients had typical gastroesophageal reflux symptoms. Follow-up was completed in 124 patients (20 had fundoplication, 32 received omeprazole, and 72 were observed). After propensity score matching, the outcome of tracheal stenosis in the fundoplication group was similar to that of the observation group (odds ratio, 1; P = .99) and better than that of the omeprazole group (odds ratio, 5.31; P = .03). The observation (no gastroesophageal reflux) group had a better outcome of stenosis than those treated with omeprazole (odds ratio, 3.54; P = .02). Conclusions: The outcome of the airway stenosis was superior after laparoscopic fundoplication compared with medical treatment with omeprazole and was similar to the outcome of patients without gastroesophageal reflux. A prospective randomized trial is warranted.
article 0 Citação(ões) na Scopus Medicina cardiovascular brasileira baseada em evidências(2011) PEGO-FERNANDES, Paulo Manuel; BIBAS, Benoit Jacques- Brazilian airway surgery survey indicates low overall numbers and need for improved teaching skills(2024) BIBAS, Benoit Jacques; MINAMOTO, Helio; CARDOSO, Paulo Francisco G.; CREMONESE, Mariana Rodrigues; PEGO-FERNANDES, Paulo Manuel; TERRA, Ricardo MingariniOBJECTIVES The Brazilian Society of Thoracic Surgeons conducted an online survey to determine the number of surgeons that perform adult and paediatric airway surgery and to understand the practice patterns along the country.METHODS Active members were electronically invited to complete the questionnaire through the REDCapR platform. Invitations were sent from January to April 2020. The survey encompassed 40 questions that explored 4 different topics in the assessment of tracheal diseases: (i) surgeon's demography; (ii) institutional profile, (iii) education and training in laryngo-tracheal surgery and (iv) preoperative and postoperative evaluation.RESULTS Eighty-nine percentage of the responders declared to perform tracheal surgery with a median of 5 tracheal resection procedures per year [interquartile range (IQR) 3-12]. Interaction with other specialties occurs in 37.3% of cases. Access to technology and devices is highly variable across the country. Resident training in airway surgery consists in traditional lectures in 97% of the cases. Training in animals (15.2%), cadavers (12.1%) and simulators (6.1%) are rare. Preoperatory evaluation encompasses flexible bronchoscopy (97.8%) and/or computed tomography (CT) scan of the airways (90.6%). Swallowing (20.1%) and voice (14.4%) disorders are rarely evaluated. Eighty-nine percentage of the surgeons consider bronchoscopy to be the preoperatory gold-standard exam, followed by CT scan (38.8%) and CT-3D reconstruction (37.4%).CONCLUSIONS Brazilian surgeons refer that airway resection and reconstruction are part of their current practice, but the total number of procedures per surgeon per year is low. Access to high-end technology and equipment is heterogenous. Training offered to residents in most academic institutions relies on traditional lectures. Surgery of the trachea is a highly specialized field.
- Surgical Management of Benign Acquired Tracheoesophageal Fistulas: A Ten-Year Experience(2016) BIBAS, Benoit Jacques; CARDOSO, Paulo Francisco Guerreiro; MINAMOTO, Helio; ELOY-PEREIRA, Leandro Picheth; TAMAGNO, Mauro Federico L.; TERRA, Ricardo Mingarini; PEGO-FERNANDES, Paulo ManoelBackground. Benign tracheoesophageal fistulas (TEFs) are rare, and surgical correction is the ideal method of treatment. The objective of this study was to evaluate the results of operative treatment of benign TEFs in patients from a tertiary referral center. Methods. Retrospective study of patients with benign TEFs who were treated between January 2005 and December 2014. Preoperative evaluation included computed tomography of the chest, bronchoscopy, and upper endoscopy. Preoperative treatment included nutritional support by gastrostomy and treatment of lung infections. Surgical repair was done with tracheal resection and reconstruction, laryngotracheal resection, or membranous tracheal repair without resection. Esophageal management consisted of two-layer closure. Results. Twenty patients (11 men) with mean age 48 +/- 17 years were included. The most frequent cause was postintubation injury (n = 16; 80%). The median TEF length was 9 mm (interquartile range [IQR], 2 to 25 mm).The most commonly used surgical approaches were cervicotomy (n =15; 75%) and cervicosternotomy (n = 3; 15%). Eleven patients required tracheal resection; median length was 3 cm (IQR, 3 to 5.5 cm). Seven patients (35%) required intraoperative tracheostomy. Complications occurred in 55% of patients. There was one dehiscence of the tracheal anastomosis, and one procedure-related death. Ninety-five percent of patients had complete closure of the TEF occurred in 95% of cases. Two patients had tracheal stenosis recurrence, and one patient had both TEF and tracheal stenosis recurrence. Two patients have indwelling silicone tracheal stents. Conclusions. Surgical treatment of TEF is effective. Nonetheless, morbidity and mortality are not negligible, even when performed at a referral center and after appropriate preoperative evaluation. (C) 2016 by The Society of Thoracic Surgeons
- Decannulation in Tracheal Stenosis Deemed Inoperable Is Possible After Long-Term Airway Stenting(2013) TERRA, Ricardo Mingarini; BIBAS, Benoit Jacques; MINAMOTO, Helio; WAISBERG, Daniel Reis; TAMAGNO, Mauro Federico Luis; TEDDE, Miguel Lia; PEGO-FERNANDES, Paulo Manuel; JATENE, Fabio BiscegliBackground. Decannulation is the ultimate therapeutic goal for patients who undergo stenting because of inoperable benign tracheal stenosis. In this study, our objectives were to evaluate whether long-term airway stenting allows decannulation in patients with benign tracheal stenosis who were deemed inoperable and to identify possible predictive factors for successful decannulation (SD). Methods. Retrospective cohort study including all patients with inoperable benign tracheal stenosis who underwent tracheal stenting in our tertiary-care university-based institution from 1998 to 2008. For benign stenosis, we use only silicone stents (T tubes, Dumon stents, and Y stents). The main outcome was SD, which was defined as removal of the tracheal stent followed by absence of respiratory symptoms and no requirement for new dilation procedures for at least 6 months. A Kaplan-Meier curve was built to evaluate SD in 5 years, and we used a Cox model to evaluate predictors for a SD. Results. Ninety-two patients were included, and during the study period 21 were decannulated. However, 2 of them had to undergo new airway procedures and were considered to represent failure. Therefore, 19 patients were successfully decannulated. According to the Kaplan-Meier estimate, the SD rate in 5 years was 27.5%. The mean follow-up time after SD was 34.3 +/- 33.9 months (range, 6 to 108 months). Cox regression showed only 1 significant factor: tracheostomy before stent insertion caused a threefold increase in the likelihood of the patient remaining with a tracheal stent (p = 0.048). Conclusions. Tracheal stenting may be considered a curative therapeutic approach in as many as 27.5% of patients with inoperable benign tracheal stenosis. (Ann Thorac Surg 2013;95:440-4) (c) 2013 by The Society of Thoracic Surgeons
- Predictors for Postoperative Complications After Tracheal Resection(2014) BIBAS, Benoit Jacques; TERRA, Ricardo Mingarini; OLIVEIRA JUNIOR, Antonio Lopes; TAMAGNO, Mauro Federico Luis; MINAMOTO, Helio; CARDOSO, Paulo Francisco Guerreiro; PEGO-FERNANDES, Paulo ManuelBackground. Tracheal resection and anastomosis is the gold standard for the treatment of tracheal stenosis. The objective of this study is to evaluate the complications after tracheal resection for benign stenosis and the predicting factors for such complications. Methods. A retrospective study was made involving patients with benign tracheal or laryngotracheal stenosis who underwent surgical resection and reconstruction between February 2002 and January 2009. Complications related and unrelated to the anastomosis were studied. Categorical variables were presented as percentage and continuous variables as mean and standard deviation. Predicting factors were determined by univariate analysis. Factors with p less than 0.05 were used for multivariate regression. Logistic regression models were also employed for dependent variables. Statistical significance was set for p less than 0.05. Results. Ninety-four patients (18 female, 76 male) were included. Complications occurred in 42 (44.6%). Twenty-one percent had anastomotic complications. The most common complication was restenosis (16%). Nonanastomotic complications occurred in 23.2%. Wound infection occurred in 10.6%. Clinical comorbidities, previous tracheal resection, and the length of tracheal resection were statistically significant factors for complications. Previous tracheal resection was the most significant factor and was highly associated with anastomotic complications (odds ratio 49.965, p = 0.012). The greatest number of complications was found in the laryngotracheal reconstruction group, and in resections more than 4 cm. Mean follow-up was 19 +/- 14 months. At the end of the study, 86 patients (91.4%) were breathing normally. There was no mortality in this series. Conclusions. Comorbidities, previous tracheal resection, and the length of tracheal resection more than 4 cm were statistically significant factors for the onset of complications. (C) 2014 by The Society of Thoracic Surgeons
- Disseminated multi-organ tuberculosis(2011) BIBAS, Benoit Jacques; FERNANDEZ, Angelo; PEGO-FERNANDES, Paulo Manuel; JATENE, Fabio Biscegli
- Hybrid Desobstruction of Blind-end Subglottic Stenosis With Long-term Stenting(2021) CREMONESE, Mariana Rodrigues; BIBAS, Benoit Jacques; MINAMOTO, Helio; PEGO-FERNANDES, Paulo Manuel; CARDOSO, Paulo Francisco GuerreiroBlind-end stenosis (Myer-Cotton IV) is an extreme response to airway injury, resulting in phonatory ablation and dependence on a tracheostomy. A minimally invasive airway desobstruction and stenting can be beneficial in such cases. We present 2 cases of Myer-Cotton IV stenosis that were treated with a minimally invasive desobstruction using a hybrid (endoscopic-surgical) approach followed by the placement of a silicone T-tube. (C) 2021 by The Society of Thoracic Surgeons