IVAN CECCONELLO

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Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina - Líder

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Agora exibindo 1 - 10 de 22
  • article 18 Citação(ões) na Scopus
    Abnormalities of Reproductive Function in Male Obesity Before and After Bariatric Surgery-A Comprehensive Review
    (2015) ROSENBLATT, Alberto; FAINTUCH, Joel; CECCONELLO, Ivan
    Young males represent one of the populations with the steepest increases in the incidence of obesity. They are also prone to significant derangements in sexual health and fertility. Despite a growing number of reports about female reproductive health, in the setting of bariatric surgery, males have received much less attention. In the current review of reproductive abnormalities in severe obese males before and after bariatric surgery, erectile function, hypothalamic-pituitary-gonadal axis status, sex hormones, semen quality, fertility and assisted reproductive techniques, along with analysis of adipokines, gut hormones, and environmental factors are addressed. Available evidence about weight loss benefits, both medical and surgical, are highlighted, along with perspectives for future investigations, which may be relevant for the patient, for the couple, and for the community alike.
  • article 15 Citação(ões) na Scopus
    Liver resection for the treatment of post-cholecystectomy biliary stricture with vascular injury
    (2015) PERINI, Marcos V.; HERMAN, Paulo; MONTAGNINI, Andre L.; JUKEMURA, Jose; COELHO, Fabricio F.; KRUGER, Jaime A.; BACCHELLA, Telesforo; CECCONELLO, Ivan
    AIM: To report experience with liver resection in a select group of patients with postoperative biliary stricture associated with vascular injury. METHODS: From a prospective database of patients treated for benign biliary strictures at our hospital, cases that underwent liver resections were reviewed. All cases were referred after one or more attempts to repair bile duct injuries following cholecystectomy (open or laparoscopic). Liver resection was indicated in patients with Strasberg E3/E4 (hilar stricture) bile duct lesions associated with vascular damage (arterial and/or portal), ipsilateral liver atrophy/abscess, recurrent attacks of cholangitis, and failure of previous hepaticojejunostomy. RESULTS: Of 148 patients treated for benign biliary strictures, nine (6.1%) underwent liver resection; eight women and one man with a mean age of 38.6 years. Six patients had previously been submitted to open cholecystectomy and three to laparoscopic surgery. The mean number of surgical procedures before definitive treatment was 2.4. All patients had Strasberg E3/E4 injuries, and vascular injury was present in all cases. Eight patients underwent right hepatectomy and one underwent left lateral sectionectomy without mortality. Mean time of follow up was 69.1 mo and after long-term follow up, eight patients are asymptomatic. CONCLUSION: Liver resection is a good therapeutic option for patients with complex postoperative biliary stricture and vascular injury presenting with liver atrophy/abscess in which previous hepaticojejunostomy has failed.
  • conferenceObject
    EFFICACY OF TRIDIMENSIONAL ENDORECTAL ULTRASOUND IN COMPARISON TO HISTOPATHOLOGY FOR EVALUATION EXTRA PERITONEAL RECTAL NEOPLASMS.
    (2015) PINTO, R.; CORREA NETO, I.; NAHAS, S.; NAHAS, C.; MARQUES, C.; RIBEIRO JUNIOR, U.; BUSTAMANTE-LOPEZ, L.; SOARES, D.; CECCONELLO, I.
  • article 27 Citação(ões) na Scopus
    Desmoid tumors: clinical features and outcome of an unpredictable and challenging manifestation of familial adenomatous polyposis
    (2015) CAMPOS, Fabio Guilherme; MARTINEZ, Carlos Augusto Real; NOVAES, Marleny; NAHAS, Sergio Carlos; CECCONELLO, Ivan
    Background/Aims Desmoid tumors (DTs) are rare, locally invasive neoplasms that may affect 10-25 % of familial adenomatous polyposis (FAP) patients. Our aim was to evaluate incidence and clinical presentation among our patients, the potential impact on FAP outcome and to discuss treatment. Materials and methods Charts from 133 FAP (1977-2013) were reviewed. Patients with DTs were separated to retrieve demographic, clinical and management data. Follow-up was focused on disease evolution causing complications or death. Results 19 (14.3 %) DTs were diagnosed, either after previous trauma (16) or during FAP surgery (3). This group comprised 8 men (42.1 %) and 11 women (57.9 %) with an average age of 32.9 years. Intervals from surgical trauma to DTs ranged from 7 to 60 months. ECMs were detected in 12 (63.1 %) patients. DTs were located in the abdominal wall (8), abdominal cavity (8), abdominal wall and cavity (2) and left arm (1). Five patients (26.3 %) referred family history of DTs. Patients presented severe complications such as small bowel obstruction (4) and hydronephrosis (2), being directly responsible for death in three patients. Conclusions (1) DTs developed in 14.3 % of FAP, mostly after surgical trauma; (2) 30 % caused severe morbidity; (3) identification of clinical risk factors may help surgeons to develop screening and therapeutic decisions.
  • conferenceObject
    OBSERVATION VERSUS SURGICAL RESECTION IN PATIENTS WITH RECTAL CANCER WHO ACHIEVED COMPLETE CLINICAL RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY: PRELIMINARY RESULTS OF A RANDOMIZED TRIAL (NCT02052921).
    (2015) NAHAS, S.; NAHAS, C.; RIBEIRO JUNIOR, U.; MARQUES, C. Sparapan; COTTI, G. C.; IMPERIALE, A.; ORTEGA, C.; AZAMBUJA, R.; CHEN, A.; HOFF, P.; CECCONELLO, I.
  • article 791 Citação(ões) na Scopus
    International Consensus on Standardization of Data Collection for Complications Associated With Esophagectomy Esophagectomy Complications Consensus Group (ECCG)
    (2015) LOW, Donald E.; ALDERSON, Derek; CECCONELLO, Ivan; CHANG, Andrew C.; DARLING, Gail E.; D'JOURNO, Xavier Benoit; GRIFFIN, S. Michael; HOELSCHER, Arnulf H.; HOFSTETTER, Wayne L.; JOBE, Blair A.; KITAGAWA, Yuko; KUCHARCZUK, John C.; LAW, Simon Ying Kit; LERUT, Toni E.; MAYNARD, Nick; PERA, Manuel; PETERS, Jeffrey H.; PRAMESH, C. S.; REYNOLDS, John V.; SMITHERS, B. Mark; LANSCHOT, J. Jan B. van
    Introduction: Perioperative complications influence long- and short-term outcomes after esophagectomy. The absence of a standardized system for defining and recording complications and quality measures after esophageal resection has meant that there is wide variation in evaluating their impact on these outcomes. Methods: The Esophageal Complications Consensus Group comprised 21 high-volume esophageal surgeons from 14 countries, supported by all the major thoracic and upper gastrointestinal professional societies. Delphi surveys and group meetings were used to achieve a consensus on standardized methods for defining complications and quality measures that could be collected in institutional databases and national audits. Results: A standardized list of complications was created to provide a template for recording individual complications associated with esophagectomy. Where possible, these were linked to preexisting international definitions. A Delphi survey facilitated production of specific definitions for anastomotic leak, conduit necrosis, chyle leak, and recurrent nerve palsy. An additional Delphi survey documented consensus regarding critical quality parameters recommended for routine inclusion in databases. These quality parameters were documentation on mortality, comorbidities, completeness of data collection, blood transfusion, grading of complication severity, changes in level of care, discharge location, and readmission rates. Conclusions: The proposed system for defining and recording perioperative complications associated with esophagectomy provides an infrastructure to standardize international data collection and facilitate future comparative studies and quality improvement projects.
  • conferenceObject
    ANEMIA BEFORE AND AFTER BARIATRIC SURGERY: PREVALENCE AND EVOLUTION ON LONG-TERM FOLLOW UP
    (2015) SANTO, Marco; FUKUMOTO, Miwa; KANASHIRO, Newton; CURADO, Taina; DANTAS, Anna; JOAQUIM, Henrique; GARMS, Alan; RICCIOPPO, Daniel; CLEVA, Roberto; CECCONELLO, Ivan
  • conferenceObject
    LATE POSTOPERATIVE OUTCOME OF ROUX-EN-Y GASTRIC BYPASS IN MORBIDLY OBESE PATIENTS - ANALYSIS OF THE INFLUENCE OF GASTROINTESTINAL HORMONES IN WEIGHT REGAIN
    (2015) SANTO, Marco; RICCIOPPO, Daniel; PAJECKI, Denis; KAWAMOTO, Flavio; JOAQUIM, Henrique; CLEVA, Roberto; ANTONANGELO, Leila; MARCAL, Lia; GARMS, Alan; CECCONELLO, Ivan
  • article 1 Citação(ões) na Scopus
    Endoscopic stent for treatment of esophagojejunostomy fistula
    (2015) RAMOS, Marcus Fernando Kodama Pertille; MARTINS, Bruno da Costa; ALVES, Aline Marcilio; MALUF-FILHO, Fauze; RIBEIRO-JÚNIOR, Ulysses; ZILBERSTEIN, Bruno; CECCONELLO, Ivan
  • article 3 Citação(ões) na Scopus
    Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure
    (2015) SALLUM, Rubens Antonio Aissar; PADRÃO, Eduardo Messias Hirano; SZACHNOWICZ, Sergio; SEGURO, Francisco C. B. C.; BIANCHI, Edno Tales; CECCONELLO, Ivan
    BACKGROUND: Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. AIM: To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. METHODS: Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. RESULTS: From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. CONCLUSIONS: Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the same prevalence of cholelithiasis. Gallstones occurred more in GERD patients without Barrett's esophagus. Simultaneous laparoscopic cholecystectomy was proved safe.