IATAGAN ROCHA JOSINO
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- Comparison between Enteroscopy-Based and Laparoscopy-Assisted ERCP for Accessing the Biliary Tree in Patients with Roux-en-Y Gastric Bypass: Systematic Review and Meta-analysis(2018) PONTE-NETO, Alberto Machado da; BERNARDO, Wanderley M.; COUTINHO, Lara M. de A.; JOSINO, Iatagan Rocha; BRUNALDI, Vitor Ottoboni; MOURA, Diogo T. H.; SAKAI, Paulo; KUGA, Rogerio; MOURA, Eduardo G. H. deAlthough balloon-assisted enteroscopy-endoscopic retrograde cholangiopancreatography (BAE-ERCP) is a well-described means of accessing the duodenal papilla in patients with Roux-en-Y gastric bypass (RYGB), it is associated with modest clinical success rates. Laparoscopy-assisted ERCP (LA-ERCP)performed by advancing a standard duodenoscope through a gastrostomy into the excluded stomach and duodenumhas emerged as a viable alternative to BAE-ERCP, with apparently higher success rates. In this systematic review, we compare LA-ERCP with enteroscopy-based techniques in post-RYGB patients, including 22 case series that provided data on papilla identification, papilla cannulation, and complications. We found that LA-ERCP was superior to the enteroscopy-based techniques in its capacity to reach the duodenal papilla, although complication rates were lower for the latter. Comparative studies are needed in order to corroborate our findings.
article Pancreatic Metastasis from Papillary Thyroid Carcinoma: A Case Report(2020) MACHADO, Andressa A.; LENZ, Luciano; DOMINGUES, Regina B.; LIMA, Gustavo R. A.; JOSINO, Iatagan R.; CORDERO, Martin A. C.; V, Adriana Safatle-Ribeiro; MARTINS, Bruno C.; PENNACCHI, Caterina M. P. S.; GUSMON, Carla C.; PAULO, Gustavo A.; LIMA, Marcelo S.; BABA, Elisa R.; KAWAGUTI, Fabio S.; UEMURA, Ricardo S.; MALUF-FILHO, FauzeIntroduction differentiated thyroid carcinoma presents with distant metastasis in 4% of cases, usually occurring in the lungs, bones and thoracic lymph nodes. Pancreatic involvement is extremely rare, with few cases reported in the literature. Case report A 47-years-old female patient presented abdominal pain. She had a history of papillary thyroid carcinoma surgically resected in 2009. After 10 years, computed tomography revealed hepatic lesions suggestive of secondary involvement and a solid mass in the pancreatic head. Endoscopic ultrasound fine-needle aspiration was performed in a heterogeneous hypoechoic mass located at pancreatic head. Cell block with immunohistochemistry was positive for thyroglobulin, suggesting papillary thyroid carcinoma metastasis. The patient still survives at present, treating metastasis with Cabozantinib. Conclusion endoscopic ultrasound fine-needle aspiration is a minimally invasive and accurate method of sampling lesions of the pancreas. In combination with clinical history and immunohistochemistry, can confirm diagnosis and define management.- Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer(2023) JOSINO, Iatagan R.; MARTINS, Bruno C.; MACHADO, Andressa A.; LIMA, Gustavo R. de A.; CORDERO, Martin A. C.; POMBO, Amanda A. M.; SALLUM, Rubens A. A.; JR, Ulysses Ribeiro; BARON, Todd H.; MALUF-FILHO, FauzeBackground/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMSERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer. Methods: This retrospective study was performed at the Instituto do Cancer do Estado de Sao Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study. Results: Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15-5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01- 4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26-0.85; p=0.01). No difference was observed in overall survival. Conclusions: The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.
conferenceObject IMPACT OF RADIOTHERAPY (RT) ON ADVERSE EVENTS OF SELF-EXPANDING METALLIC STENTS (SEMS) IN PATIENTS WITH ESOPHAGEAL CANCER(2020) MACHADO, Andressa A.; MARTINS, Bruno da Costa; LIMA, Gustavo R.; JOSINO, Iatagan; CORONEL, Martin A.; LIMA, Marcelo S. de; SAFATLE-RIBEIRO, Adriana V.; PENNACCHI, Caterina; GUSMON, Carla C.; BABA, Elisa; KAWAGUTI, Fabio S.; LENZ, Luciano H.; UEMURA, Ricardo S.; PAULO, Gustavo A. de; GEIGER, Sebastian N.; SALLUM, Rubens A.; RIBEIRO, Ulysses; MALUF-FILHO, FauzeconferenceObject ESOPHAGORESPIRATORY FISTULAS INDUCED BY SEMS IN THE TREATMENT OF MALIGNANT ESOPHAGEAL STRICTURES(2020) JOSINO, Iatagan R.; MACHADO, Andressa A.; LIMA, Gustavo R.; CORONEL, Martin A.; LIMA, Marcelo S. de; KAWAGUTI, Fabio S.; GUSMON, Carla C.; UEMURA, Ricardo S.; PENNACCHI, Caterina; LENZ, Luciano; SAFATLE-RIBEIRO, Adriana V.; BABA, Elisa; GEIGER, Sebastian N.; PAULO, Gustavo A. de; MARTINS, Bruno da Costa; MALUF-FILHO, Fauze- The Effectiveness of Endoscopic Gastroplasty for Obesity Treatment According to FDA Thresholds: Systematic Review and Meta-Analysis Based on Randomized Controlled Trials(2018) MADRUGA-NETO, Antonio Coutinho; BERNARDO, Wanderley Marques; MOURA, Diogo Turiani Hourneaux de; BRUNALDI, Vitor Ottoboni; MARTINS, Rafael Krieger; JOSINO, Iatagan Rocha; MOURA, Eduardo Turiani Hourneaux de; SOUZA, Thiago Ferreira de; SANTO, Marco Aurelio; MOURA, Eduardo Guimares Hourneaux deEndoscopic bariatric therapies (EBTs) are promising alternatives to conventional surgery for obesity. The aim of this study is to compare efficacy and safety through a systematic review and meta-analysis of the endoscopic gastroplasty techniques versus conservative treatment. We searched MEDLINE, EMBASE, Cochrane CENTRAL, Lilacs/Bireme. Randomized controlled trials (RCTs) enrolling obese patients comparing endoscopic gastroplasty to sham or diet/exercise were considered eligible. Among 6014 records, three RCTs were selected for meta-analysis. The total sample was 459 patients (312 EBTs vs 147 control). Mean total body weight loss in the intervention group (IG) was 4.8% higher than the control group (CG) at 12 months (p = 0.01). The IG responder rate was 44.31% at 12 months. Therefore, the endoscopic gastroplasty is more effective than conservative therapies but do not achieve FDA thresholds.
conferenceObject COMPARISON OF COVERED VS. UNCOVERED SELF-EXPANDABLE METAL STENTS FOR PALLIATION OF DISTAL MALIGNANT BILIARY STRICTURES(2020) LIMA, Gustavo R.; MARTINS, Bruno da Costa; CORONEL, Martin A.; JOSINO, Iatagan R.; MACHADO, Andressa A.; KAWAGUTI, Fabio S.; LIMA, Marcelo S. de; PENNACCHI, Caterina; LENZ, Luciano H.; UEMURA, Ricardo S.; PAULO, Gustavo A. de; GUSMON, Carla C.; BABA, Elisa; GEIGER, Sebastian N.; RIBEIRO, Ulysses; SAFATLE-RIBEIRO, Adriana V.; MALUF-FILHO, Fauze- Gastric foreign body removal with a lithotriptor(2018) PONTE NETO, A. Machado da; JOSINO, I. R.; MARQUES, S. B.; MADRUGA NETO, A. C.; IDE, E.; YAMAZAKI, K.; ALVES, T. A. F. de Almeida; MOURA, E. G. Hourneaux de[No abstract available]
conferenceObject DIAGNOSTIC EVALUATION OF CLINICAL COMPLETE RESPONSE BY PROBE-BASED CONFOCAL ENDOMICROSCOPY AFTER NEOADJUVANT CHEMORADIATION FOR LOCALLY ADVANCED RECTAL ADENOCARCINOMA(2020) SAFATLE-RIBEIRO, Adriana V.; MARQUES, Carlos F.; PIRES, Clelma Batista; ARRAES, Livia; MEIRELLES, Luciana; BABA, Elisa R.; MACHADO, Andressa A.; CORONEL, Martin A.; LIMA, Gustavo R.; JOSINO, Iatagan; ARAUJO, Diogo; PELEGRINELLI-ZAIDAN, Evelise; GUSMON, Carla C.; LIMA, Marcelo S. de; PENNACCHI, Caterina; KAWAGUTI, Fabio S.; UEMURA, Ricardo S.; MARTINS, Bruno da Costa; PAULO, Gustavo A. de; LENZ, Luciano; COTTI, Guilherme C.; NAHAS, Caio Sergio R.; NAHAS, Sergio C.; RIBEIRO, Ulysses; MALUF-FILHO, Fauze- Impact of radiotherapy on adverse events of self-expanding metallic stents in patients with esophageal cancer(2023) MACHADO, Andressa A.; MARTINS, Bruno C.; JOSINO, Iatagan R.; CHEN, Andre T. C.; HONG, Carlos B. C.; SANTOS, Alisson L. D. R.; LIMA, Gustavo R. A.; CORDERO, Martin A. C.; V, Adriana Safatle-Ribeiro; PENNACCHI, Caterina; GUSMON, Carla C.; PAULO, Gustavo A.; LENZ, Luciano; LIMA, Marcelo S.; BABA, Elisa R.; KAWAGUTI, Fabio S.; UEMURA, Ricardo S.; SALLUM, Rubens A. A.; JR, Ulysses Ribeiro; MALUF-FILHO, FauzeSelf-expanding metallic stents (SEMS) are considered the treatment of choice for the palliation of dysphagia and fistulas in inoperable esophageal neoplasms. However, the safety of SEMSs in patients who received or who will be submitted to radiotherapy (RT) is uncertain. The study aimed to evaluate the impact of RT on adverse events (AEs) in patients with esophageal cancer with SEMSs. This is a retrospective study conducted at a tertiary cancer hospital from 2009 to 2018. We collected information regarding RT, the histological type of the tumor, the model of SEMSs and AEs after stent placement. Three hundred twenty-three patients with malignant stenosis or fistula were treated with SEMSs. The predominant histological type was squamous cell carcinoma (79.6%). A total of 282 partially covered and 41 fully covered SEMSs were inserted. Of the 323 patients, 182 did not received RT, 118 received RT before SEMS placement and 23 after. Comparing the group that received RT before stent insertion with the group that did not, the first one presented a higher frequency of severe pain (9/118 7.6% vs. 3/182 1.6%; P = 0.02). The group treated with RT after stent placement had a higher risk of global AEs (13/23 56.5% vs. 63/182 34.6%; P = 0.019), ingrowth/overgrowth (6/23 26.1% vs. 21/182 11.5%; P = 0.045) and gastroesophageal reflux (2/23 8.7% vs. 2/182 1.1%; P = 0.034). Treatment with RT before stent placement in patients with inoperable esophageal neoplasm prolongs survival and is associated with an increased risk of severe chest pain. Treatment with RT of patients with an esophageal stent increases the frequency of minor, not life-threatening AEs.