AMANDA AQUINO DE MIRANDA POMBO
Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer(2023) JOSINO, Iatagan R.; MARTINS, Bruno C.; MACHADO, Andressa A.; LIMA, Gustavo R. de A.; CORDERO, Martin A. C.; POMBO, Amanda A. M.; SALLUM, Rubens A. A.; JR, Ulysses Ribeiro; BARON, Todd H.; MALUF-FILHO, FauzeBackground/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMSERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer. Methods: This retrospective study was performed at the Instituto do Cancer do Estado de Sao Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study. Results: Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15-5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01- 4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26-0.85; p=0.01). No difference was observed in overall survival. Conclusions: The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.
conferenceObject RISK FACTORS FOR STENOSIS AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION OF LARGE LESIONS OF THE RECTUM(2021) REZENDE, Daniel T.; KAWAGUTI, Fabio S.; MARTINS, Bruno; SAFATLE-RIBEIRO, Adriana V.; NAHAS, Caio Sergio R.; MARQUES, Carlos F.; POMBO, Amanda A.; SANTOS, Alisson L.; BRAGHIROLI, Oddone F.; RIBEIRO, Ulysses; NAHAS, Sergio C.; MALUF-FILHO, Fauze- Tube-in-tube endoscopic vacuum therapy for the closure o upper gastrointestinal fistulas, leaks, and perforations(2022) LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; GUSMON-OLIVEIRA, Carla Cristina; POMBO, Amanda Aquino de Miranda; MARTINS, Bruno Costa; LENZ, Luciano; KAWAGUTI, Fabio Shiguehissa; PAULO, Gustavo Andrade De; BABA, Elisa Ryoka; V, Adriana Safatle-Ribeiro; RIBEIRO, Ulysses; MONKEMULLER, Klaus; MALUF-FILHO, FauzeBackground Although endoscopic vacuum therapy (EVT) has been successfully used to treat postoperative upper gastrointestinal (UGI) wall defects, its use demands special materials and several endoscopic treatment sessions. Herein, we propose a technical modification of EVT using a double tube (tube-in-tube drain) without polyurethane sponges for the drainage element. The tube-in-tube drainage device enables irrigation and application of suction. A flowchart for standardizing the management of postoperative UGI wall defects with this device is presented. Methods An EVT modification was made to achieve frequent fistula cleansing, with 3% hydrogen peroxide rinsing, and the application of negative pressure. A tube-in-tube drain without polyurethane sponges can be inserted like a nasogastric tube or passed through a previously positioned surgical drain. This was a retrospective two-center observational study, with data collected from 30 consecutive patients. Technical success, clinical success, adverse events, time under therapy, interval time from procedure to fistula diagnosis and treatment start, size of transmural defect, volume of cavity, number of endoscopic treatment sessions, and mortality were reviewed. Results 30 patients with UGI wall defects were treated. The technical and clinical success rates were 100% and 86.7%, respectively. Three patients (10%) had adverse events and three patients (10%) died. The median time under therapy was of 19 days (range 1-70) and the median number of endoscopic sessions was 3 (range 1-9). Conclusions This standardized approach and EVT modification using a tube-in-tube drain, with frequent fistula cleansing, were successful and safe in a wide variety of UGI wall defects.
- Tube-in-tube endoscopic vacuum therapy for treatment of colorectal anastomotic leaks: A low-cost, patient-friendly, feasible and efficient technical modification of sponge-based endoscopic vacuum therapy(2023) LIMA, Marcelo Simas de; FIGUEIREDO, Lucas Zouain; FURUYA, Carlos Kiyoshi; POMBO, Amanda Aquino de Miranda; HORA, Jose Americo Bacchi; MALLUF-FILHO, FauzeBackground and Aims: Colorectal endoscopic vacuum therapy (CR EVT) is usually performed using sponges passed through the anus. It may be associated with patient discomfort and displacement of the aspiration tube. Methods: With the tube-in-tube endoscopic vacuum therapy modification (CR TT-EVT), it is possible to position the aspiration tube in the pelvic cavity through the abdominal wall. In addition, it allows frequent cleaning of the fistula, eliminates the need for programmed device changes, and enables a standardized approach to such a wide variety of fistulas, leaks, and perforations. Results: Here is a technical note on how to perform CR TT-EVT, while we are at the early phase of our case series we have reached 100% of technical success.