EDUARDO GUSTAVO PIRES DE ARRUDA
Índice h a partir de 2011
6
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Avaliação do índice de infecção de implantes mamários utilizados na reconstrução de mama do Instituto do Câncer do Estado de São Paulo(2014) ALMEIDA, PATRÍCIA NORONHA DE; ARRUDA, EDUARDO GUSTAVO PIRES DE; OKADA, ALBERTO; MONTAG, EDUARDO; FERREIRA, MARCUS CASTRO; BUSNARDO, FÁBIO FREITAS; FONSECA, ALEXANDRE SIQUEIRAABSTRACT Introduction: Placement of breast implants is the most commonly used form of breast reconstruction. Despite its advantages, infection of the implant, either in the tissue expander or mammary prosthesis, can be a significant problem, including the need to remove it. The objective of this work is to evaluate the infection rate of breast implants used for breast reconstruction in patients submitted to surgery at the Cancer Institute of the State of São Paulo (ICESP), as well as its correlation with clinical, oncological, and surgical factors. Patients and methods: This is a retrospective study on 120 patients submitted to breast reconstruction with breast implants at the ICESP from February 2009 to March 2010. Results: The infection rate (24.3%) was statistically related to immediate reconstruction (88.9%), diabetes mellitus (25%), body mass index >30 (52.8%), systemic arterial hypertension (52.8%), and skin injury due to mastectomy (27.8%). Of the infected implants, 44% were removed, most of which were expanders placed during immediate reconstruction. Conclusions: Breast reconstruction with implants is the safest and most effective form of treatment. However, consideration should be given to patients who are prone to the development of infection, in order to optimize its prevention and attempt to perform its treatment at an early stage.
- Immediate chest wall reconstruction during pregnancy: Surgical management after extended surgical resection due to primary sarcoma of the breast(2014) ARRUDA, Eduardo Gustavo; MUNHOZ, Alexandre Mendonca; MONTAG, Eduardo; FILASSI, Jose Roberto; GEMPERLI, RolfBackground: Breast sarcoma during pregnancy is an extremely rare event and represents a complex problem because of a more advanced stage at presentation. Method: This report presents the first case of a 24-year-old woman with a gestational age of 20 weeks with a fast growing tumour in her left breast (29 x 19 x 15 cm) and infiltrating the skin/pectoralis muscles. Radical mastectomy was performed with a gestational age of 22 weeks and a different design was planned for the latissimus dorsi musculocutaneous flap (LDMF) with primary closure in the V-Y pattern. Result: Satisfactory chest wall coverage and contour were achieved. Final histopathological findings allowed a diagnosis of undifferentiated sarcoma. With a gestational age of 37 weeks, a healthy infant was delivered by means of a caesarean section. The patient is currently in the second postoperative year and no recurrence has been observed. Conclusion: Management of a large breast sarcoma in a pregnant patient presents unique challenges in consideration of the potential risks to the foetus and the possible maternal benefit. The results of this study demonstrate that the VY-LDMF is a reliable technique and should be considered in cases of immediate large thoracic wound reconstruction.
- The use of contralateral free extended latissimus dorsi myocutaneous flap for a tertiary failed breast reconstruction: Is it still an option?(2016) MUNHOZ, Alexandre Mendonca; MONTAG, Eduardo; ARRUDA, Eduardo Gustavo; OKADA, Alberto; FONSECA, Alexandre; FILASSI, Jose Roberto; GEMPERLI, RolfBackground: Unsuccessful breast reconstruction management represents a complex challenge for the plastic surgeon. Although these events rarely occur, many patients are not suitable candidates for conventional flaps, because of either previous donor-site surgery or lack of sufficient tissue. Methods: In this study, a contralateral free latissimus dorsi musculocutaneous flap (CL-LDMF) was planned for correction of major lesions in the anterior chest wall. Twelve patients underwent secondary/tertiary breast reconstruction with CL-LDMF with a customized shape (horizontal, oblique, or ""fleur-de-lis"") depending on the amount of tissue necessary. The technique was indicated in patients with large thoracic defects who lacked a donor site and had undergone previous unsuccessful pedicled LDMF. Results: The mean follow-up time was 42.5 months (range: 18-72 months). Five local complications occurred in four of the 12 patients. Dorsal dehiscence was observed in one, local wound infection in one, small partial CL-LDMF necrosis in one, and dorsal seroma in one patient. All cases of complications were limited and treated with a conservative approach except for one implant extrusion 4 months after reconstruction. No total flap loss was reported. All patients achieved a satisfactory thoracic and breast reconstruction. Conclusion: The results of this study demonstrate that free CL-LDMF is a reliable technique and should be considered in selected cases of tertiary reconstructions. The majority of complications were immediate, minor, and comparable to other reconstructive techniques. We believe that in selected patients, especially those who do not have available donor-site areas, free CL-LDMF is advantageous and should be part of the armamentarium of all plastic surgeons who deal with tertiary breast reconstructions.