ANDRE LUIS MONTAGNINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- ELEVATED CA 19-9 IN AN ASYMPTOMATIC PATIENT: WHAT DOES IT MEAN?(2022) MEIRA-JUNIOR, Jose Donizeti de; COSTA, Thiago Nogueira; MONTAGNINI, Andre Luis; NAHAS, Sergio Carlos; JUKEMURA, Jose
- Biliary tract schwannoma: A rare cause of obstructive jaundice in a young patient(2012) FONSECA, Gilton Marques; MONTAGNINI, Andre Luis; ROCHA, Manoel de Souza; PATZINA, Rosely Antunes; BERNARDES, Mario Vinicius Angelete Alvarez; CECCONELLO, Ivan; JUKEMURA, JoseSchwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastrointestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumor did not recur in any of the resected cases.
- BRAZILIAN CONSENSUS ON INCIDENTAL GALLBLADDER CARCINOMA(2020) COIMBRA, Felipe Jose F.; TORRES, Orlando Jorge M.; ALIKHANOV, Ruslan; AGARWAL, Anil; PESSAUX, Patrick; FERNANDES, Eduardo de Souza M.; QUIREZE-JUNIOR, Claudemiro; ARAUJO, Raphael Leonardo C.; GODOY, Andre Luis; WAECHTER, Fabio Luis; RESENDE, Alexandre Prado de; BOFF, Marcio Fernando; COELHO, Gustavo Rego; REZENDE, Marcelo Bruno de; LINHARES, Marcelo Moura; BELOTTO, Marcos; MORAES-JUNIOR, Jose Maria A.; AMARAL, Paulo Cezar G.; PINTO, Rinaldo Danesi; GENZINI, Tercio; LIMA, Agnaldo Soares; RIBEIRO, Heber Salvador C.; RAMOS, Eduardo Jose; ANGHINONI, Marciano; PEREIRA, Lucio Lucas; ENNE, Marcelo; SAMPAIO, Adriano; MONTAGNINI, Andre Luis; DINIZ, Alessandro; JESUS, Victor Hugo Fonseca de; SIROHI, Bhawna; V, Shailesh Shrikhande; PEIXOTO, Renata D. Alpino; KALIL, Antonio Nocchi; JARUFE, Nicolas; SMITH, Martin; HERMAN, PauloBackground: Incidental gallbladder cancer is defined as a cancer discovered by histological examination after cholecystectomy. It is a potentially curable disease. However, some questions related to their management remain controversial and a defined strategy is associated with better prognosis. Aim: To develop the first evidence-based consensus for management of patients with incidental gallbladder cancer in Brazil. Methods: Sixteen questions were selected, and 36 Brazilian and International members were included to the answer them. The statements were based on current evident literature. The final report was sent to the members of the panel for agreement assessment. Results: Intraoperative evaluation of the specimen, use of retrieval bags and routine histopathology is recommended. Complete preoperative evaluation is necessary and the reoperation should be performed once final staging is available. Evaluation of the cystic duct margin and routine 16b1 lymph node biopsy is recommended. Chemotherapy should be considered and chemoradiation therapy if microscopically positive surgical margins. Port site should be resected exceptionally. Staging laparoscopy before reoperation is recommended, but minimally invasive radical approach only in specialized minimally invasive hepatopancreatobiliary centers. The extent of liver resection is acceptable if R0 resection is achieved. Standard lymph node dissection is required for T2 tumors and above, but common bile duct resection is not recommended routinely. Conclusions: It was possible to prepare safe recommendations as guidance for incidental gallbladder carcinoma, addressing the most frequent topics of everyday work of digestive and general surgeons.
- Prognostic significance of epidermal growth factor receptor overexpression in pancreas cancer and nodal metastasis(2015) PERINI, Marcos Vinicius; MONTAGNINI, Andre Luis; COUDRY, Renata; PATZINA, Rosely; PENTEADO, Sonia; ABDO, Emilio Elias; DINIZ, Alessandro; JUKEMURA, Jose; CUNHA, Jose Eduardo Monteiro daBackgroundIdentification of molecular markers in pancreatic adenocarcinoma (PA) has the potential to guide targeted therapy. The objective of this study is to determine the prognostic significance of epidermal growth factor receptor (EGFR) expression (membrane and cytoplasmic) in resected PA and its correlation with lymph node metastasis and survival. MethodsEGFR overexpression was determined by immunohistochemistry, and the pattern of expression was compared between the primary tumour, adjacent normal pancreas and involved lymph nodes. ResultsA total of 88 patients had curative resection. No difference was found in mEGFR overexpression between tumoural and metastatic nodal tissues (P = 0.28). Median overall survival time was 22.9 months. Overall cumulative 1-, 3- and 5-year survival was 48%, 20% and 18%, respectively. In positive mEGFR tumour expression, survival was 46% at 1 year, 8% at 3 years and 0% at 5 years (P < 0.05). Univariate analysis showed that male gender, portal vein (PV) resection, perineural, lymphovascular and peri-pancreatic invasion, positive margins and positive mEGFR expression in tumour tissue had worse survival. Multivariate analysis showed that male gender, PV resection, vascular and perineural invasion remained independent predictors of poor survival. ConclusionPositive mEGFR overexpression is associated with decreased survival; however, it is not an independent prognostic factor.
- COVERED SELF-EXPANDABLE METALLIC STENT VERSUS PLASTIC STENTS FOR ANASTOMOTIC BILIARY STRICTURES AFTER LIVER TRANSPLANTATION: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS(2019) MORIBE, Daniel; D'ASSUNCAO, Marco A.; COSTA, Lucas S. Nova da; HONDO, Fabio Y.; MONTAGNINI, Andre Luis
- Complex biliary stones management: cholangioscopy versus papillary large balloon dilation - a randomized controlled trial(2018) FRANZINI, Tomazo; MOURA, Renata Nobre; BONIFACIO, Priscilla; LUZ, Gustavo Oliveira; SOUZA, Thiago Ferreira de; SANTOS, Marcos Eduardo Lera dos; RODELA, Gustavo Luis; IDE, Edson; HERMAN, Paulo; MONTAGNINI, Andre Luis; D'ALBUQUERQUE, Luiz Augusto Carneiro; SAKAI, Paulo; MOURA, Eduardo Guimaraes Hourneaux deBackground and study aims Endoscopic removal of biliary stones has high success rates, ranging between 85% to 95%. Nevertheless, some stones may be challenging and different endoscopic methods have evolved. Papillary large balloon dilation after sphincterotomy is a widely used technique with success rates ranging from 68 to 90% for stones larger than 15mm. Cholangioscopy allows performing lithotripsy under direct biliary visualization, either by laser or electrohydraulic waves, which have similar success rate (80%-90%). However, there is no study comparing these 2 techniques. Patients and methods From April 2014 to June 2016, 100 patients were enrolled and randomized in 2 groups, using a non-inferiority hypothesis: cholangioscopy+electrohydraulic lithotripsy (group 1) and endoscopic papillary large balloon dilation (group 2). The main outcome was complete stone removal. Adverse events were documented. Mechanical lithotripsy was not performed. Failure cases had a second session with crossover of the methods. Results The mean age was 56 years. 74 (75.5%) patients were female. The initial overall complete stone removal rate was 74.5% (77.1% in group 1 and 72% in group 2, P >0.05). After second session the overall success rate achieved 90.1%. Procedure time was significantly lower in group 2,-25.2min (CI95%-12.48 to -37.91). There were no significant differences regarding technical success rate, radiologic exposure and adverse events. Conclusion Single-operator cholangioscopy-guided lithotripsy and papillary large balloon dilation are effective and safe approaches for removing complex biliary stones.
- LIVER RESECTION IN BRAZIL: A NATIONAL SURVEY(2018) FONSECA, Gilton Marques; JEISMANN, Vagner Birk; KRUGER, Jaime Arthur Pirola; COELHO, Fabricio Ferreira; MONTAGNINI, Andre Luis; HERMAN, PauloBackground: Liver surgery has developed significantly in the past decades. In Brazil, the interest on it has grown significantly, but there is no study regarding its clinical practice. Despite intrinsic limitations, surveys are well suited to descriptive studies and allow understanding the current scenario. Aim: To provide an overview on the current spread of liver surgery in Brazil, focusing on groups' profile, operative techniques and availability of resources. Method: From May to November 2016, was conducted a national survey about liver surgery profile in Brazil composed by 28 questions concerning surgical team characteristics, technical preferences, surgical volume, results and available institutional resources. The survey was sent by e-mail to 84 liver surgery team leaders from different centers including all regions of the country. Results: Forty-three study participants (51.2%), from all Brazilian regions, responded the survey. Most centers have residency/fellowship programs (86%), perform and do laparoscopic procedures (91%); however, laparoscopy is still responsible for a little amount of surgeries (1-9% of laparoscopic procedures over all liver resections in 39.5% of groups). Only seven centers (16.3%) perform more than 50 liver resections/year. Postoperative mortality rate is between 1-3% in 55% of the centers. Conclusion: This is the first depiction of liver surgery in Brazil. It showed a surgical practice aligned with worldwide excellence centers, concentrated on hospitals dedicated to academic practice.