RODRIGO OLIVA PEREZ
Índice h a partir de 2011
25
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Unidades Organizacionais
4 resultados
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- Role of Simulation-Based Training in Minimally Invasive and Robotic Colorectal Surgery(2021) ARAUJO, Sergio Eduardo Alonso; PEREZ, Rodrigo Oliva; KLAJNER, SidneyProperly performing minimally invasive colorectal procedures requires specific skills. With a focus on patient safety, the training of surgeons on patients is only accepted under exceptionally controlled, expensive, and challenging conditions. Moreover, many new techniques in colorectal surgery have been developed. Therefore, undertaking minimally invasive colorectal surgery in modern times requires specific psychomotor skills that trainee surgeons must gather in less time. In addition, there are not enough proctors with sufficient expertise for such an expressive number of new different techniques likes transanal and robotic procedures. Studies that have demonstrated an improvement in minimally invasive surgery skills to the actual operating room in general surgery and a stepwise approach to surgical simulation with a combination of various training methods appears to be useful in colorectal surgery training programs. However, the scientific evidence on the transfer of skills specifically for colorectal surgery is extremely scarce and very variable. Thus, the evaluation of the results remains quite difficult. In this review, we present the best available evidence on the types of training based on simulation, their characteristics, advantages and disadvantages, and finally the results available on their adoption. Nevertheless, scientific evidence about the benefit of simulation training in minimally invasive colorectal surgery is limited and there is a need to build more robust evidence.
- Organ-preservation strategies in rectal cancer: advances and challenges(2017) FERNANDEZ, Laura Melina; PEREZ, Rodrigo Oliva
- Alternative treatment to surgery for rectal cancer(2018) HABR-GAMA, Angelita; FERNANDEZ, Laura Melina; JULIAO, Guilherme Pagin Sao; VAILATI, Bruna Borba; PEREZ, Rodrigo OlivaThe traditional concept of rectal cancer management has changed significantly over the last few years. Although surgical resection remains central the treatment of distal rectal cancer by proctectomy and total mesorectal excision (TME), there has been increased interest in organ preservation strategies. Neoadjuvant chemoradiation (nCRT) may result in significant tumor regression and complete pathological response may be observed in up to 42% of patients. In order to avoid the morbidity, mortality and functional consequences of major surgery, selected patients with clinical and radiological evidence of significant tumor regression after nCRT have been managed non-operatively with strict follow-up (Watch & Wait Strategy-WW) with acceptable outcomes and minimal functional consequences. In addition, close surveillance may allow early detection of local recurrences and salvage alternatives with no oncological compromise.
- Role of magnetic resonance imaging in organ-preserving strategies for the management of patients with rectal cancer(2019) ORTEGA, Cinthia D.; PEREZ, Rodrigo O.Total mesorectal excision has been the most effective treatment strategy adopted to reduce local recurrence rates among patients with rectal cancer. The morbidity associated with this radical surgical procedure led surgeons to challenge the standard therapy particularly when dealing with superficial lesions or good responders after neoadjuvant radiotherapy, to which radical surgery may be considered overtreatment. In this subset of patients, less invasive procedures in an organ-preserving strategy may result in good oncological and functional outcomes. In order to tailor the most appropriate treatment option, accurate baseline staging and reassessment of tumor response are relevant. MRI is the most robust tool for the precise selection of patients that are candidates for organ preservation; therefore, radiologists must be familiar with the criteria used to guide the management of these patients. The purpose of this article is to review the relevant features that radiologists should know in order to provide valuable information during the multidisciplinary discussion and ultimate management decision.