FRANCISCO TUSTUMI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
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- Combined liver and multivisceral resections: A comparative analysis of short and long-term outcomes(2020) JUNIOR, Sergio S.; COELHO, Fabricio F.; TUSTUMI, Francisco; CASSENOTE, Alex J. F.; JEISMANN, Vagner B.; FONSECA, Gilton M.; KRUGER, Jaime A. P.; ERNANI, Lucas; CECCONELLO, Ivan; HERMAN, PauloBackground En bloc liver and adjacent organs resections are technically demanding procedures. Few case series and nonmatched comparative studies reported the outcomes of multivisceral liver resections (MLRs). Objectives To compare the short and long-term outcomes of patients submitted MLRs with those submitted to isolated hepatectomies. Methods From a prospective database, a case-matched 1:2 study was performed comparing MLRs and isolated hepatectomy. Additionally, a risk analysis was performed to evaluate the association between MLRs and perioperative morbidity, mortality, and long-term survival. Results Fifty-three MLRs were compared with 106 matched controls. Patients undergoing MLRs had longer operative time (430 [320-525] vs 360 [270-440] minutes,P = .005); higher estimated blood loss (600 [400-800] vs 400 [100-600] mL;P = .011); longer hospital stay (8 [6-14] vs 7 [5-9] days;P = .003); and higher postoperative mortality (9.4% vs 1.9%,P = .042). Number of resected organs was not an independent prognostic factor for perioperative major complications (odds ratio [OR], 1 organ = 1.8 [0.54-6.05]; OR >= 2, organs = 4.0 [0.35-13.84]) or perioperative mortality (OR, 1, organ = 5.2 [0.91-29.51]; OR >= 2, organs = 6.5 [0.52-79.60]). No differences in overall (P = .771) and disease-free survival (P = .28) were observed. Conclusion MLRs are feasible with acceptable morbidity but relatively high perioperative mortality. MLRs did not negatively affect long-term outcomes.
- Esophagojejunostomy after total gastrectomy: A systematic review and meta-analysis comparing hand-sewn and stapled anastomosis(2022) HONORIO, Fernanda Cavalcanti Cabral; TUSTUMI, Francisco; PINHEIRO FILHO, Joao Emilio Lemos; MARQUES, Stefanie Sophie Buuck; GLINA, Felipe Placco Araujo; HENRIQUES, Alexandre Cruz; DIAS, Andre Roncon; WAISBERG, JaquesThis review aims to evaluate the surgical outcomes of hand-sewn esophageal anastomosis compared to mechanical anastomosis to reconstruct total gastrectomy. A systematic review and meta-analysis of comparative studies evaluating hand-sewn and stapled anastomosis were performed. A total of 12 studies were selected, comprising 1761 individuals. The results indicate that the hand-sewn and stapled esophageal anastomosis have similar surgical outcomes. Stapled anastomosis has a shorter operation time.
- The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer(2020) TUSTUMI, Francisco; TAKEDA, Flavio Roberto; VIYUELA, Mateus Silva; CRUZ JUNIOR, Jurandir Batista da; BRANDAO, Antonio Adolfo Guerra Soares; SALLUM, Rubens Antonio Aissar; RIBEIRO JUNIOR, Ulysses; CECCONELLO, IvanBackground Inflammation status plays an important role in the natural history of malignancy. Consequently, hematological markers of systemic inflammation may predict prognosis in neoplasms. This study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by esophagectomy for cancer in predicting prognosis. Methods A cohort of 149 patients was analyzed. Cellular components of blood were assessed before neoadjuvant therapy (A); before surgery (B); and 3 to 5 months after surgery (C); for the following outcomes: pathological response, overall survival (OS), and disease-free survival (DFS). Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. Results Low hematocrit (Ht) (C) (HR, 0.85; 95% CI, 0.79-0.92) and high neutrophil-to-lymphocyte ratio (NLR) (C) (HR, 1.07; 95% CI, 1.07-1.10) were related to poor OS. Low Hb (C) (HR, 0.72; 95% CI, 0.58-0.88), red cell distribution width (RDW) (C-A) (HR, 1.16; 95% CI, 1.02-1.31), and NLR (C-A) (1.06; 95% CI, 1.03-1.09) were related to poor DFS. RDW (B-A) (HR, 1.15; 95% CI, 1.08-1.22), RDW (C) (HR, 1.12; 95% CI, 1.04-1.2), NLR (C) (HR, 1.12; 95% CI, 1.08-1.17) were related to systemic recurrence. Conclusion Variables of routine blood count are easily assessable and their changes throughout trimodal therapy for esophageal carcinoma provide important information for cancer patient's prognosis.
- Is early extubation after esophagectomy safe? A systematic review and meta-analysis(2022) SERAFIM, Maria Carolina Andrade; ORLANDINI, Marina Feliciano; DATRINO, Leticia Nogueira; TAVARES, Guilherme; TRISTAO, Luca Schiliro; SANTOS, Clara Lucato dos; PINHEIRO FILHO, Joao Emilio Lemos; BERNARDO, Wanderley Marques; TUSTUMI, FranciscoThere is no consensus on the timing of extubation after esophagectomy. There is a fear that premature extubation may result in a high risk of urgent reintubation. On the other hand, there is a risk of lung damage in prolonged intubation. The present systematic review compares early and late extubation. Five articles were selected. Early extubation after esophagectomy does not increase the risk of reintubation, mortality, complications, and length of stay.
- Prophylactic thoracic duct obliteration and resection during esophagectomy: What is the impact on perioperative risks and long-term survival? A systematic review and meta-analysis(2022) SANTOS, Clara L. dos; SANTOS, Laura L. dos; TAVARES, Guilherme; TRISTAO, Luca S.; ORLANDINI, Marina F.; SERAFIM, Maria C. A.; DATRINO, Leticia N.; BERNARDO, Wanderley M.; TUSTUMI, FranciscoThere is no agreement whether prophylactic thoracic duct ligation (TDL), with or without resection, during esophagectomy for patients with cancer is beneficial. The effects of these procedures on postoperative complications and overall survival remain unclear. This systematic review included 16 articles. TDL did not influence short- and long-term outcomes. However, thoracic duct resection increased postoperative chylothorax and overall complications, with no improvement in survival.
- Two- versus three-field lymphadenectomy for esophageal cancer. A systematic review and meta-analysis of early and late results(2022) DATRINO, Leticia Nogueira; ORLANDINI, Marina Feliciano; SERAFINN, Maria Carolina Andrade; SANTOS, Clara Lucato dos; MODESTO, Victoria Andrade; TAVARES, Guilherme; TRISTAO, Luca Schilird; BERNARDO, Wanderley M.; TUSTUNNI, FranciscoThis study aims to estimate whether prophylactic cervical lymphadenectomy for esophageal cancer influences the short- and long-term results through a systematic literature review and meta-analysis. Twenty-eight articles were selected in this systematic review, encompassing 9180 patients. Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution, as it is associated with worse short-term results compared to traditional two-field lymphadenectomy and does not improve long-term survival.