MARIA SYLVIA IERARDI RIBEIRO
Projetos de Pesquisa
Unidades Organizacionais
7 resultados
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Agora exibindo 1 - 7 de 7
- An easier option for endoscopic ultrasound-guided biliary drainage: cannulation using two antiparallel guidewires(2016) RIBEIRO, Maria Sylvia I.; FRANCO, Matheus Caval-cante; MALUF-FILHO, Fauze
- ERCP with balloon-overtube-assisted enteroscopy in postsurgical anatomy(2016) FRANCO, Matheus Cavalcante; SAFATLE-RIBEIRO, Adriana Vaz; GUSMON, Carla Cristina; RIBEIRO, Maria Sylvia I.; MALUF-FILHO, Fauze
conferenceObject Validation of Classic and Expanded Criteria for Endoscopic Submucosal Dissection of Early Gastric Cancer: 7 Years of Experience of a Western Tertiary Cancer Center(2017) MENDONCA, Ernesto Q.; OLIVEIRA, Joel F.; RIBEIRO, Maria Sylvia I.; SAFATLE-RIBEIRO, Adriana V.; MARTINS, Bruno da Costa; GUSMON, Carla C.; BABA, Elisa R.; PENNACCHI, Caterina; KAWAGUTI, Fabio S.; LENZ, Luciano; PAULO, Gustavo A. de; SORBELLO, Mauricio; UEMURA, Ricardo S.; GEIGER, Sebastian N.; LIMA, Marcelo S. de; RIBEIRO, Ulysses; MALUF-FILHO, Fauze- Validation of classic and expanded criteria for endo-scopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center(2018) MENDONCA, Ernesto Quaresma; PESSORRUSSO, Fernanda Cristina Simoes; RAMOS, Marcus Fernando Kodama Pertille; JACOB, Carlos Eduardo; OLIVEIRA, Joel Fernandez de; RIBEIRO, Maria Sylvia; SAFATLE-RIBEIRO, Adriana; ZILBERSTEIN, Bruno; RIBEIRO JUNIOR, Ulysses; MALUF-FILHO, FauzeOBJECTIVE: Our aim was to evaluate the Japan Gastroenterological Endoscopy Society criteria for endoscopic submucosal resection of early gastric cancer (EGC) based on the experience in a Brazilian cancer center. METHODS: We included all patients who underwent endoscopic submucosal resection for gastric lesions between February 2009 and October 2016. Demographic data and information regarding the endoscopic resection, pathological report and follow-up were obtained. Statistical calculations were performed with Fisher's exact test and chi-square tests, with 95% confidence intervals. RESULTS: In total, 76% of the 51 lesions were adenocarcinomas, 16% were adenomas, and 8% had other diagnoses. The average size was 19.9 mm (+/- 11.7). The average procedure length was 113.9 minutes (+/- 71.4). The complication rate was 21.3%, with only one patient who needed surgical treatment (transmural perforation). Among the adenocarcinomas, 39.5% met the classic criteria for curability, 31.6% met the expanded criteria and 28.9% met the criteria for noncurative resection. Analysis of the indication criteria and curability revealed differences among cases with ""only-by-size"" expanded criteria (64.28%), other expanded criteria (40%) and classic criteria (89.47%), with a p-value of 0.049. During follow-up (15.8 months; +/- 14.3), 86.1% of the EGC patients had no recurrence. When well-differentiated and poorly differentiated lesions or lesions included in the classic and expanded criteria were compared, there were no differences in recurrence. The noncurative group presented a higher recurrence rate than the classic group (p=0.014). CONCLUSION: These results suggest that the Japanese endoscopic submucosal resection criteria might be useful for endoscopic treatment of EGC in Western countries.
conferenceObject Predictive Factors of Clinical Failure After Endoscopic Stenting of Malignant Esophagorespiratory Fistulas(2016) RIBEIRO, Maria Sylvia I.; MARTINS, Bruno; FRANCO, Matheus C.; LIMA, Marcelo S.; RETES, Felipe A.; SAFATLE-RIBEIRO, Adriana V.; GUSMON, Carla C.; SALLUM, Rubens A.; RIBEIRO, Ulysses; MALUF-FIHO, Fauze- Adverse events of self-expandable esophageal metallic stents in patients with long-term survival from advanced malignant disease(2017) MEDEIROS, Vitor Sousa; MARTINS, Bruno Costa; LENZ, Luciano; RIBEIRO, Maria Sylvia Ierardi; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas; SAFATLE-RIBEIRO, Adriana Vaz; KAWAGUTI, Fabio Shiguehissa; PENNACCHI, Caterina; GEIGER, Sebastian N.; BASTOS, Victor R.; RIBEIRO-JUNIOR, Ulysses; SALLUM, Rubens A.; MALUF-FILHO, FauzeBackground and Aims: Self-expandable metallic stents are considered the best palliative treatment of dysphagia for patients with advanced esophageal cancer. Adverse events (AEs) are a major concern, especially in patients with better prognosis and longer survival. The present study aimed to evaluate the AEs of patients who survived longer than 6 months with esophageal stents in place. Methods: This is a retrospective analysis of a prospectively collected database including all patients submitted to esophageal stent placement for the palliation of malignant diseases during the period from February 2009 to February 2014 at a tertiary care academic center who had stents longer than 6 months. Results: Sixty-three patients were included. Mean follow-up was 10.7 months. Clinical success was achieved in all patients, and the median stent patency was 7.1 months. AEs occurred in 40 patients (63.5%), totaling 62 AEs (mean, 1.5 AEs per patient). Endoscopic management of AEs was successful in 84.5% of cases, with a mean of 1.6 reinterventions per patient. The univariate analysis revealed that performance status, age, and post-stent radiotherapy presented a trend to higher risk of AEs. The multivariate analysis revealed that only performance status was associated with AEs (P = .025; hazard ratio, 4.1). Conclusions: AEs are common in patients with long-term esophageal stenting for malignancy. However, AEs were not related to higher mortality rate, and most AEs could be successfully managed by endoscopy. Only performance status was a risk factor for AEs. Our data suggest that metallic stenting is a valid option for the treatment of malignant esophageal conditions, even when survival longer than 6 months is expected.
- Self-expandable metal stent for malignant esophagorespiratory fistula: predictive factors associated with clinical failure(2018) RIBEIRO, Maria Sylvia Ierardi; MARTINS, Bruno da Costa; LIMA, Marcelo Simas de; FRANCO, Matheus Cavalcante; SAFATLE-RIBEIRO, Adriana Vaz; MEDEIROS, Vitor de Sousa; BASTOS, Victor Rossi; KAWAGUTI, Fabio Shiguehissa; SALLUM, Rubens Antonio Aissar; RIBEIRO JR., Ulysses; MALUF-FILHO, FauzeBackground and Aims: Malignant esophagorespiratory fistulas (MERFs) usually are managed by the placement of self-expandable metal stents (SEMSs) but with conflicting results. This study aimed to identify risk factors associated with clinical failure after SEMS placement for the treatment of MERFs. Methods: This was a retrospective analysis of a prospectively maintained database used at a tertiary-care cancer hospital, with patients treated with SEMS placement for MERFs between January 2009 and February 2016. Logistic regression was used to identify predictive factors for clinical outcomes and to estimate the odds ratio (OR) and the 95% confidence interval (CI). The Kaplan-Meier method was used for survival analysis, and comparisons were made by using the log-rank test. Results: A total of 71 patients (55 male, mean age 59 years) were included in the study, and 70 were considered for the final analysis (1 failed stent insertion). Clinical failure occurred in 44% of patients. An Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4 and fistula development during esophageal cancer treatment were associated with an increased risk of clinical failure. ECOG status of 3 or 4, pulmonary infection at the time of SEMS placement, and prior radiation therapy were predictive factors associated with lower overall survival. Dysphagia scores improved significantly 15 days after stent insertion. The overall stent-related adverse event rate was 30%. Stent migration and occlusion caused by tumor overgrowth were the most common adverse events. Conclusion: SEMS placement is a reasonable treatment option for MERFs; however, ECOG status of 3 or 4 and fistula development during esophageal cancer treatment may be independent predictors of clinical failure after stent placement.