NIURA NORO HAMILTON
Projetos de Pesquisa
Unidades Organizacionais
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
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bookPart Simpatectomia torácica unilateral ou bilateral simultânea(2023) CAMPOS, José Ribas Milanez; TEDDE, Miguel Lia; HAMILTON, Niura Noro; WOLOSKER, Nelson; KAUFFMAN, Paulo- A prospective controlled randomized multicenter study to evaluate the severity of compensatory sweating after one-stage bilateral thoracic sympathectomy versus unilateral thoracic sympathectomy in the dominant side(2020) HAMILTON, Niura Noro; TEDDE, Miguel Lia; WOLOSKER, Nelson; AGUIAR, Wolfgang William Schmidt; FERREIRA, Hylas Paiva da Costa; OLIVEIRA, Humberto Alves de; LIMA, Alexandre Marcelo Rodrigues; WESTPHAL, Fernando Luiz; OLIVEIRA, Marina Varela Braga de; RIUTO, Fabio de Oliveira; PEREIRA, Sergio Tadeu Lima F.; REZENDE, Guilherme Cancado; VALERO, Caroline Elizabeth Brero; PEGO-FERNANDES, Paulo M.Objective: To evaluate the contribution that unilateral thoracic sympathectomy in dominant side or two-stage bilateral thoracic sympathectomy can have as strategies to reduce the incidence of compensatory sweating after sympathectomy for palmar hyperhidrosis. Methods: This is a prospective, controlled, randomized multicenter trial of 200 participants with palmar hyperhidrosis, which will be randomized into two arms: (a) one-stage bilateral thoracic sympathectomy (control arm); or (b) unilateral thoracic sympathectomy in dominant side (intervention arm). At six months the participants submitted to unilateral procedure can make the contralateral surgery if they wanted it, creating a third group called two-stage bilateral sympathectomy. Participants will be evaluated for the degree of sweating by the Hyperhidrosis Disease Severity Scale (HDSS) and of quality of life questionnaires. Results: 96 participants out of the 200 proposed have been included so far, with 48 participants randomized to each arm. From the sample 61 (63.5%) are female, with a mean age of 24 (20-32) years. There were exclusive palmar hiperhydrosis in 14 cases (14.5%), palmar and plantar hyperhidrosis in 36 (37.5%) cases, palmar and axillar hyperhidrosis in 12 (12,5%) cases and palmar-axillary-plantar hyperhidrosis in 34 (35,4%) cases. The age at the beginning of the disease was childhood (78%), with mean of time of disease 15 (11-22) years. Conclusions: If one or both hypothesis: (a) unilateral sympathectomy in dominant hand is a satisfactory treatment; b) two-stage bilateral sympathectomy causes less compensatory sweating than in one stage are confirmed there is a chance that surgical therapy for palmar hyperhidrosis can be changed for better.
- Quality of life outcomes after minimally invasive repair of pectus excavatum utilizing a new set of metallic bars and stabilizers(2021) CARVALHO, Rafael Lucas Costa de; TEDDE, Miguel Lia; CAMPOS, Jose Ribas Milanese de; HAMILTON, Niura Noro; GUILHERME, Gustavo Falavigna; SOUSA, Vanessa Moreira; SALOMAO JUNIOR, Vitor Floriano; SAVAZZI, Flavio Henrique; PEGO-FERNANDES, Paulo ManuelBackground/Purpose: The aim of the study was to evaluate the postoperative quality of life (QoL) of patients who underwent minimally invasive repair of pectus excavatum (MIRPE) with a newly designed bar and bar stabilizers. Methods: We conducted a prospective randomized study in which patients were operated either with standard perpendicular stabilizers (control group) or with the newly designed oblique stabilizers (intervention group). All patients were evaluated 6 months after the operation with the Pectus Excavatum Evaluation Questionnaire (PEEQ). Results: There were 16 patients in the control group and 14 in the intervention group. Mean age was 17 (SD: 3.3, range 14-27) years. There were no demographic differences between groups. Two patients in the control group and one in the intervention group were repaired with two bars instead of one. There was one reoperation in each group. There was a significant difference between the pre- and postoperative scores, in both groups, in the patient body image domain (control group: 9.5 to 3; p < 0.01: intervention group 10 to 3: p < 0.01), as well as in the psychosocial domain (control group: 13.5 to 24, p < 0.01: intervention group: 15 to 24, p < 0.01). With regards to the patients' perception of physical difficulties before and after MIRPE, the difference between pre- and postoperative scores was greater in the intervention group (8 to 12, p < 0.01) than in the control group (10 to 11, p = 0.04). The mean length of stay was 45 and 5 days in the intervention group and the control group, respectively. Conclusion: Our study showed that patients who underwent MIRPE with the newly designed barsand stabilizers had non-inferior outcomes than patients reported in the literature who underwent MIRPE with standard bars and stabilizers. We found slightly better outcomes in patients in the intervention group compared to the control group, but larger studies will be needed to confirm if those differences are statistically significant.