DIEGO FERNANDES MAIA SOARES
Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
9 resultados
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Agora exibindo 1 - 9 de 9
conferenceObject THE EVOLUTION OF COLORECTAL SURGERY LAPAROSCOPY IN A TEACHING INSTITUTION.(2017) GERBASI, L.; CAMARGO, M.; PINTO, R.; KIMURA, C.; SOARES, D.; NAHAS, S.; CECCONELLO, I.conferenceObject LAPAROSCOPIC RIGHT COLECTOMY WITH EXTRACORPOREAL ANASTOMOSIS HAS HIGHER MORBIDITY COMPARED TO INTRACORPOREAL ANASTOMOSIS?(2017) PINTO, R.; GERBASI, L.; CAMARGO, M.; KIMURA, C.; SOARES, D.; BUSTAMANTE-LOPEZ, L.; NAHAS, C.; CAMPOS, F.; CECCONELLO, I.; NAHAS, S.- IS LAPAROSCOPIC REOPERATION FEASIBLE TO TREAT EARLY COMPLICATIONS AFTER LAPAROSCOPIC COLORECTAL RESECTIONS?(2020) PINTO, Rodrigo Ambar; BUSTAMANTE-LOPEZ, Leonardo Alfonso; SOARES, Diego Fernandes Maia; NAHAS, Caio Sergio R.; MARQUES, Carlos Frederico S.; CECCONELLO, Ivan; NAHAS, Sergio CarlosBackground: Recently, with the performance of minimally invasive procedures for the management of colorectal disorders, it was allowed to extend the indication of laparoscopy in handling various early and late postoperative complications. Aim: To present the experience with laparoscopic reoperations for early complications after laparoscopic colorectal resections. Methods: Patients undergoing laparoscopic colorectal resections with postoperative surgical complications were included and re-treated laparoscopically. Selection for laparoscopic approach were those cases with early diagnosis of complications, hemodynamic stability without significant abdominal distention and without clinical comorbidities that would preclude the procedure. Results: In four years, nine of 290 (3.1%) patients who underwent laparoscopic colorectal resections were re-approached laparoscopically. There were five men. The mean age was 40.67 years. Diagnoses of primary disease included adenocarcinoma (n=3), familial adenomatous polyposis (n=3), ulcerative colitis (n=1), colonic inertia (n=1) and chagasic megacolon (n=1). Initial procedures included four total proctocolectomy with ileal pouch anal anastomosis; three anterior resections; one completion of total colectomy; and one right hemicolectomy. Anastomotic dehiscence was the most common complication that resulted in reoperations (n=6). There was only one case of an unfavorable outcome, with death on the 40th day of the first approach, after consecutive complications. The remaining cases had favorable outcome. Conclusion: In selected cases, laparoscopic access may be a safe and minimally invasive approach for complications of colorectal resection. However, laparoscopic reoperation must be cautiously selected, considering the type of complication, patient's clinical condition and experience of the surgical team.
conferenceObject ANALYSIS OF RISK FACTORS FOR POSTOPERATIVE COMPLICATIONS IN PATIENTS WHO UNDERWENT CLOSURE OF ILEOSTOMY AFTER COLORECTAL CANCER RESECTION.(2016) SOARES, D.; NAHAS, C.; CAMARGO, M.; PINTO, R.; MARQUES, C.; RIBEIRO JUNIOR, U.; NAHAS, S.; CECCONELLO, I.bookPart Abscessos anorretais(2017) NAHAS, Sérgio Carlos; SOARES, Diego Fernandes Maia; NAHAS, Caio Sérgio Rizkallah- LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS?(2023) PINTO, Rodrigo Ambar; SOARES, Diego Fernandes Maia; GERBASI, Lucas; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; BUSTAMANTE-LOPES, Leonardo Alfonso; CAMARGO, Mariane Gouvea Monteiro de; NAHAS, Sergio CarlosBACKGROUND: The laparoscopic approach considerably reduced the morbidity of colorectal surgery when compared to the open approach. Among its benefits, we can highlight less intraoperative bleeding, early oral intake, lower rates of surgical site infection, incisional hernia, and postoperative pain, and earlier hospital discharge. AIMS: To compare the perioperative morbidity of right versus left colectomy for cancer and the quality of laparoscopic oncologic resection. METHODS: Retrospective analysis of patients submitted to laparoscopic right and left colctomy between 2006 and 2016. Postoperative complications were classified using the Clavien-Dindo scale, 30 days after surgery. RESULTS: A total of 293 patients were analyzed, 97 right colectomies (33.1%) and 196 left colectomies (66.9%). The averageage was 62.8 years. The groups were comparable in terms of age, comorbidities, body mass index, and the American Society of Anesthesiology (ASA) classification. Preoperative transfusion was higher in the right colectomy group (5.1% versus 0.4%, p=0.004, p<0.05). Overall, 233 patients (79.5%) had no complications. Complications found were grade I and II in 62 patients (21.1%) and grade III to V in 37 (12.6%). Twenty-three patients (7.8%) underwent reoperation. The comparison between left and right colectomy was not statistically different for operative time, conversion, reoperation, severe postoperative complications, and length of stay. The anastomotic leak rate was comparable in both groups(5.6% versus 2.1%, p=0.232, p>0.05). The oncological results were similar in both surgeries. In multiple logistic regression, ASA statistically influenced the worst results (>= III; p=0.029, p<0.05). CONCLUSIONS: The surgical and oncological results of laparoscopic right and left colectomies are similar, making this the preferred approach for both procedures.
- IS THE PHYSICIAN EXPERTISE IN DIGITAL RECTAL EXAMINATION OF VALUE IN DETECTING ANAL TONE IN COMPARISON TO ANORECTAL MANOMETRY?(2019) PINTO, Rodrigo Ambar; CORRÊA NETO, Isaac José Felippe; NAHAS, Sérgio Carlos; FROEHNER JUNIOR, Ilario; SOARES, Diego Fernandes Maia; CECCONELLO, IvanABSTRACT BACKGROUND: Digital rectal examination (DRE) is part of the physical examination, is also essential for the colorectal surgeon evaluation. A good DRE offers precious information related to the patient’s complaints, which will help in decision making. It is simple, quick and minimally invasive. In many centers around the world, the DRE is still the only method to evaluate the anal sphincter prior to patient’s management. On the other hand, anorectal manometry (ARM) is the main method for objective functional evaluation of anal sphincter pressures. The discrepancy of DRE depending on the examiner to determine sphincter tonus in comparison to ARM motivated this study. OBJECTIVE: To compare the DRE performed by proficient and non-experienced examiners to sphincter pressure parameters obtained at ARM, depending on examiners expertise. METHODS: Thirty-six consecutive patients with complaints of fecal incontinence or chronic constipation, from the anorectal physiology clinic of the University of São Paulo School of Medicine, were prospectively included. Each patient underwent ARM and DRE performed by two senior colorectal surgeons and one junior colorectal surgeon prior to the ARM. Patient’s history was blinded for the examiner’s knowledge, also the impressions of each examiner were blinded from the others. For the DRE rest and squeeze pressures were classified by an objective scale (DRE scoring system) that was compared to the parameters of the ARM for the analysis. The results obtained at the ARM were compared to the DRE performed by the seniors and the junior colorectal surgeons. STATISTICAL ANALYSIS: Descriptive analysis was performed for all parameters. For the rest and squeeze pressures the Gamma index was used for the comparison between the DRE and ARM, which varied from 0 to 1. The closer to 1 the better was the agreement. RESULTS: The mean age was 48 years old and 55.5% of patients were female. The agreement of rest anal pressures between the ARM and the DRE performed by the senior proficient examiners was 0.7 (CI 95%; 0.32-1.0), while for the junior non-experienced examiner was 0.52 (CI 95%; 0.09-0.96). The agreement of squeeze pressures was 0.96 (CI 95%; 0.87-1.0) for the seniors and 0.52 (CI 95%; 0.16-0.89) for the junior examiner. CONCLUSION: More experienced colorectal surgeons used to DRE had a more significant agreement with the ARM, thereafter would have more appropriate therapeutic management to patients with sphincter functional problems. ARM, therefore, persists as an important exam to objectively evaluate the sphincter complex, justifying its utility in the clinical practice.
conferenceObject PROGNOSTIC FACTORS AFFECTING OUTCOMES IN MULTIVISCERAL EN BLOC RESECTION FOR COLORECTAL CANCER.(2016) NAHAS, C.; NAHAS, S.; MARQUES, C.; PINTO, R.; BUSTAMANTE, L.; COTTI, G.; IMPERIALE, A.; RIBEIRO JUNIOR, U.; NAHAS, W.; SOARES, D.; HOFF, P.; CECCONELLO, I.conferenceObject IS THERE A DIFFERENCE IN SURGICAL AND ONCOLOGICAL OUTCOMES COMPARING RIGHT WITH LEFT LAPAROSCOPIC COLECTOMY FOR COLON CANCER?(2017) PINTO, R.; GERBASI, L.; CAMARGO, M.; KIMURA, C.; SOARES, D.; DANTAS, A.; BUSTAMANTE-LOPEZ., L.; CAMPOS, F.; CECCONELLO, I.; NAHAS, S.