RUBENS ANTONIO AISSAR SALLUM
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
6 resultados
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Agora exibindo 1 - 6 de 6
- MANAGEMENT OF SYMPTOMS RECURRENCE AFTER MYOTOMY FOR ACHALASIA. A PRACTICAL APPROACH(2023) TUSTUMI, Francisco; SZACHNOWICZ, Sergio; ANDREOLLO, Nelson Adami; SEGURO, Francisco Carlos Bernal da Costa; BIANCHI, Edno Tales; DUARTE, Andre Fonseca; NASI, Ary; SALLUM, Rubens Antonio AissarBACKGROUND: Achalasia is an esophageal motility disorder, and myotomy is one of the most used treatment techniques. However, symptom persistence or recurrence occurs in 9 to 20% of cases. AIMS: This study aims to provide a practical approach for managing the recurrence or persistence of achalasia symptoms after myotomy. METHODS: A critical review was performed to gather evidence for a rational approach for managing the recurrence or persistence of achalasia symptoms after myotomy. RESULTS: To properly manage an achalasia patient with significant symptoms after myotomy, such as dysphagia, regurgitation, thoracic pain, and weight loss, it is necessary to classify symptoms, stratify severity, perform appropriate tests, and define a treatment strategy. A systematic differential diagnosis workup is essential to cover the main etiologies of symptoms recurrence or persistence after myotomy. Upper digestive endoscopy and dynamic digital radiography are the main tests that can be applied for investigation. The treatment options include endoscopic dilation, peroral endoscopic myotomy, redo surgery, and esophagectomy, and the decision should be based on the patient's individual characteristics. CONCLUSIONS: A good clinical evaluation and the use of proper tests jointly with a rational assessment, are essential for the management of symptoms recurrence or persistence after achalasia myotomy.
- A case report of esophageal heterotopic pancreas presenting as recurrent mediastinal abscess, treated by minimally invasive esophagectomy(2019) BIANCHI, Edno Tales; TUSTUMI, Francisco; DUARTE, Andre Fonseca; ORTIZ, Evelin Sanchez; SZACHNOWICZ, Sergio; SEGURO, Francisco Carlos Bernal Costa; SALLUM, Rubens Antonio Aissar; CECCONELLO, IvanINTRODUCTION: Heterotopic pancreas is a rare congenital anomaly. We report a case of esophageal heterotopic pancreas complicated by recurrent mediastinal abscess and treated by minimally invasive resection. PRESENTATION OF CASE: A 31-year-old woman was admitted with a history of recurrent chest pain, dysphagia, and heartburn. CT scan revealed focal confined collection in the lower mediastinum surrounding esophagus. Endoscopic ultrasound revealed a subepithelial lesion. The patient was treated by minimally invasive esophagectomy and made an uneventful postoperative recovery. DISCUSSION: The management of subepithelial lesions would depend on their size, ability to exclude other etiologies and their associated symptoms. The patient, in this case, was obviously symptomatic and accurate differentiation from malignant etiologies could not be accurately made. CONCLUSION: Although pancreatic heterotopia is rare, it should be remembered in the differential diagnosis of various gastrointestinal lesions. (C) 2019 The Author(s).
- Surgical management of esophageal stenosis due to ingestion of corrosive substances(2021) TUSTUMI, Francisco; SEGURO, Francisco Carlos Bernal da Costa; SZACHNOWICZ, Sergio; BIANCHI, Edno Tales; MORRELL, Andre Luiz Gioia; SILVA, Matheus Oliveira da; DUARTE, Andre Fonseca; SOUSA, Jorge Henrique Bento de; LAUREANO, Gabriela Gomes; ROCHA, Julio Rafael Mariano da; SALLUM, Rubens Antonio Aissar; CECCONELLO, IvanBackground: Corrosive ingestion is a significant challenge for healthcare systems. Limited data are available regarding the best treatments, and there remains a lack of consensus about the optimal surgical approach and its outcomes. This study aims to review the current literature and show a single institution's experience regarding the surgical treatment of esophageal stenosis due to corrosive substance ingestion. Methods: A retrospective review that accounted for demographics, psychiatric profiles, surgical procedures, and outcomes was performed. A systematic review of the literature was performed using PubMed. Results: In total, 27 surgical procedures for esophageal stenosis due to corrosive substance ingestion were performed from 2010 to 2019. Depression and drug abuse were diagnosed in 30% and 22% of the included patients, respectively. Esophagectomies and esophageal bypasses were performed in 13 and 14 patients, respectively. No 30-day mortality was recorded. Conclusion: Surgical intervention either by esophagectomy or esophageal bypass results in durable relief from dysphagia. However, successful clinical outcomes depend on a high-quality multidisciplinary network of esophageal and thoracic surgeons, intensivists, psychologists, psychiatrists, and nutritional teams.
- Surgical treatment of Killian-Jamieson diverticulum: A case report and literature review(2019) JEISMANN, Vagner Birk; BIANCHI, Edno Tales; SZACHNOWICZ, Sergio; SEGURO, Francisco Carlos Bernal da Costa; TUSTUMI, Francisco; DUARTE, Andre Fonseca; SALLUM, Rubens Antonio Aissar; CECCONELLO, IvanThis study describes a patient with symptomatic Killian-Jamieson, a rare entity, successfully treated by cervical approach with diverticulum resection and esophagomyotomy.
- Anti-reflux surgery for controlling respiratory symptoms of gastro- esophageal reflux disease: A systematic review and meta-analysis(2021) TUSTUMI, Francisco; BERNARDO, Wanderley Marques; ROCHA, Julio Rafael Mariano da; SZACHNOWICZ, Sergio; SEGURO, Francisco Carlos Bernal da Costa; BIANCHI, Edno Tales; TAKEDA, Flavio Roberto; MIRANDA NETO, Antonio Afonso de; SALLUM, Rubens Antonio Aissar; CECCONELLO, IvanGastro-esophageal reflux disease (GERD) patients have a higher prevalence of airway symptoms, such as chronic cough, wheezing, and hoarseness. The therapeutic management of patients with these symptoms is controversial. Therefore, this study aims to perform a systematic review and meta-analysis evaluating the efficacy of anti-reflux surgery for controlling respiratory symptoms related to GERD. A systematic review and meta-analysis was performed. Extraction of the data concerning proportions of participants who were not free of respiratory symptoms related to GERD (cough, wheezing, hoarseness) or not substantially improved at follow-ups (failure to cure) was performed. Of the 3,424 initially screened articles, 68 studies were included for systematic review and 61 were included for meta analysis, with a cumulative sample size of 3,869 patients. Of all the included patients, after anti-reflux surgery, the general symptoms improvement was 80% (95% CI 75.2-84%). The numbers needed to harm (NNH) and the numbers needed to treat (NNT) were 15.21 and 1.23, respectively. Of the included patients, 83.4% (95% CI 78.3-87.5%) patients reported improvement in cough symptoms after surgery. For the wheezing symptom, 71.5% (95% CI 62.9-78.8%) reported improvement after surgery. Moreover, surgery presented better results in improving respiratory symptoms than medical therapy (risk difference:-0.46; 95% CI-0.77,-0.16). Physicians should strongly consider surgical anti-reflux procedures for controlling respiratory symptoms in GERD patients after proper patient selection. Anti-reflux surgery has shown high efficacy in improving respiratory symptoms related to GERD, even when compared to medical therapy. (C) 2020 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.
- Preoperative botulinum toxin type A: A case report of a proposed new strategy for giant hiatal hernia management(2020) TUSTUMI, Francisco; BIANCHI, Edno Tales; SZACHNOWICZ, Sergio; CEDRO, Rider May; MIRANDA NETO, Antonio Afonso de; MORRELL, Andre Luiz Gioia; ABDALLA, Ricardo Zugaib; SALLUM, Rubens Antonio Aissar; CECCONELLO, IvanThe use of preoperative ventral botulinum toxin for giant hiatal hernia management.