RODRIGO AMBAR PINTO

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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

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Autor e Coautores FMUSP-HC Normalizados: CAIO SERGIO RIZKALLAH NAHAS ×

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  • article 4 Citação(ões) na Scopus
    Long-term follow up of abdominal rectosigmoidectomy with posterior end-to-side stapled anastomosis for Chagas megacolon
    (2011) NAHAS, S. C.; PINTO, R. A.; DIAS, A. R.; NAHAS, C. S. R.; ARAUJO, S. E. A.; MARQUES, C. F. S.; CECCONELLO, I.
    Aim Chagas' disease is an endemic parasitosis found in Latin America. The disease affects different organs, such as heart, oesophagus, colon and rectum. Megacolon is the most frequent long-term complication, caused by damage to the myoenteric and submucous plexus, ultimately leading to a functional barrier to the faeces. Patients with severe constipation are managed surgically. The study aimed to analyse the 10-year minimum functional outcome after rectosigmoidectomy with posterior end-to-side anastomosis (RPESA). Method A total of 21 of 46 patients were available for follow up. Patients underwent clinical, radiological and manometric evaluation, and the results were compared with preoperative parameters. Results Of the 21 patients evaluated, 81% (17) were female, with a mean age of 60.6 years. Good function was achieved in all patients, with significant improvement in defaecatory frequency (P < 0.0001), usage of enemas (P < 0.0001) and patient satisfaction. Barium enema also showed resolution of the colonic and rectal dilatation in 19 cases evaluated postoperatively. Conclusion Minimal 10-year follow up of RPESA showed excellent functional results, with no recurrence of constipation.
  • article 3 Citação(ões) na Scopus
    Magnifying chromoendoscopy is a reliable method in the selection of rectal neoplasms for local excision
    (2023) KIMURA, C. M. S.; KAWAGUTI, F. S.; HORVAT, N.; NAHAS, C. S. R.; MARQUES, C. F. S.; PINTO, R. A.; REZENDE, D. T. de; SEGATELLI, V.; SAFATLE-RIBEIRO, A. V.; JUNIOR, U. R.; MALUF-FILHO, F.; NAHAS, S. C.
    Purpose Adequate staging of early rectal neoplasms is essential for organ-preserving treatments, but magnetic resonance imaging (MRI) frequently overestimates the stage of those lesions. We aimed to compare the ability of magnifying chromoendoscopy and MRI to select patients with early rectal neoplasms for local excision. Methods This retrospective study in a tertiary Western cancer center included consecutive patients evaluated by magnifying chromoendoscopy and MRI who underwent en bloc resection of nonpedunculated sessile polyps larger than 20 mm, laterally spreading tumors (LSTs) >= 20 mm, or depressed-type lesions of any size (Paris 0-IIc). Sensitivity, specificity, accuracy, and positive and negative predictive values of magnifying chromoendoscopy and MRI to determine which lesions were amenable to local excision (i.e., <= T1sm1) were calculated. Results Specificity of magnifying chromoendoscopy was 97.3% (95% CI 92.2-99.4), and accuracy was 92.7% (95% CI 86.7-96.6) for predicting invasion deeper than T1sm1 (not amenable to local excision). MRI had lower specificity (60.5%, 95% CI 43.4-76.0) and lower accuracy (58.3%, 95% CI 43.2-72.4). Magnifying chromoendoscopy incorrectly predicted invasion depth in 10.7% of the cases in which the MRI was correct, while magnifying chromoendoscopy provided a correct diagnosis in 90% of the cases in which the MRI was incorrect (p = 0.001). Overstaging occurred in 33.3% of the cases in which magnifying chromoendoscopy was incorrect and 75% of the cases in which MRI was incorrect. Conclusion Magnifying chromoendoscopy is reliable for predicting invasion depth in early rectal neoplasms and selecting patients for local excision.
  • article 1 Citação(ões) na Scopus
    Outcomes of surgical treatment for patients with distal rectal cancer: A retrospective review from a single university hospital
    (2020) NAHAS, S. C.; NAHAS, C. S. R.; BUSTAMANTE-LOPEZ, L. A.; PINTO, R. A.; MARQUES, C. F. S.; CECCONELLO, I.
    introduction and aim: Surgery for distal rectal cancer (DRC) can be performed with or without sphincter preservation. The aim of the present study was to analyze the outcomes of two surgical techniques in the treatment of DRC patients: low anterior resection (LAR) and abdominoperineal resection (APR). Methods: Patients with advanced DRC that underwent surgical treatment between 2002 and 2012 were evaluated. We compared the outcomes of the type of surgery (APR vs LAR) and analyzed the associations of survival and recurrence with the following factors: age, sex, tumor location, lymph nodes obtained, lymph node involvement, and rectal wall involvement. Patients with distant metastases were excluded. Results: A total of 148 patients were included, 78 of whom were females (52.7%). The mean patient age was 61.2 years. Neoadjuvant chemoradiation therapy was performed in 86.5% of the patients. APR was performed on 86 (58.1%) patients, and LAR on 62 (41.9%) patients. No differences were observed between the two groups regarding clinical and oncologic characteristics. Eighty-seven (62%) patients had pT3-4 disease, and 41 patients (27.7%) had lymph node involvement. In the multivariate analysis, only poorly differentiated tumors (P=.026) and APR (P=.009) correlated with higher recurrence rates. Mean follow-up time was 32 (16-59.9) months. Overall 5 -year survival was 58.1%. The 5 -year survival rate was worse in patients that underwent APR (46.5%) than in the patients that underwent LAR (74.2%) (P=.009). Conclusions: Patients with locally advanced DRC that underwent APR presented with a lower survival rate and a higher local recurrence rate than patients that underwent LAR. In addition, advanced T/stage, lymph node involvement, and poor tumor differentiation were associated with recurrence and a lower survival rate, regardless of the procedure. 2020 Asociacion Mexicana de Gastroenterologia.
  • conferenceObject
    POSTOPERATIVE TEM COMPLICATIONS FOR THE TREATMENT OF RECTAL NEOPLASIA ARE FREQUENT BUT MILD. RISK FACTORS AND TIME BEHAVIOR STUDY
    (2014) MARQUES, C.; NAHAS, C.; RIBEIRO, U.; BUSTAMANTE, L.; PINTO, R.; MORY, E.; CECCONELLO, I.; NAHAS, S.
  • 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.
  • 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
    PROGNOSTIC FACTORS FOR LEFT COLECTOMY FOR COLON CANCER: A TEN YEARS EXPERIENCE OF A SINGLE UNIVERSITY INSTITUTION
    (2017) NAHAS, Sergio Carlos; NAHAS, Caio Sergio; BUSTAMANTE-LOPEZ, Leonardo Alfonso; PINTO, Rodrigo Ambar; MARQUES, Carlos Frederico Sparapan; CAMPOS, Fabio Guilherme; CECCONELLO, Ivan
    ABSTRACT Background: Colorectal cancer is the third most common cancer in the world. In Brazil, it is the leading cause of cancer in the gastrointestinal tract. Aim: To evaluate the preoperative, perioperative, and postoperative risk factors for recurrence and overall survival of patients with left colon cancer operated during a ten-year period. Methods: Patients with left colon cancer surgically treated underwent clinical preoperative workout and cancer staging. The following factors were studied: gender, age, tumor location, T stage, lymph node yield, N stage, M stage, histological type, and tumor differentiation. It was analyzed the influence in five-year overall survival. Results: A total of 173 patients underwent left colectomy for colon cancer. There was a slight predominance of male gender with 50.9%. The mean age was 60.8 years old. Fifteen (8.7%) tumors were located at splenic flexure, 126 (72.8%) at sigmoid colon, and 32 (18.5%) at descending colon. The median length of hospital stay was seven days. Mean survival was 47.5 months. At 60 months seven patients (4%) lost follow-up, 38 patients (21.9%) deceased and 135 patients (78%) were alive. Overall survival time was 48 months. Conclusion: Advanced stages (T3-T4, N+ and M+) were the only factors associated with poor long term survival in left colon cancer.
  • article 0 Citação(ões) na Scopus
    Comparing three-dimensional endorectal ultrasound and magnification chromoendoscopy for early rectal neoplasia invasion depth assessment
    (2024) PINTO, Rodrigo Ambar; KAWAGUTI, Fabio Shiguehissa; KIMURA, Cintia Mayumi Sakurai; CORREA NETO, Isaac Jose Felippe; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; BUSTAMANTE-LOPEZ, Leonardo Alfonso; RIBEIRO-JR, Ulysses; MALUF-FILHO, Fauze; NAHAS, Sergio Carlos
    IntroductionAccurate assessment of invasion depth of early rectal neoplasms is essential for optimal therapy. We aimed to compare three-dimensional endorectal ultrasound (3D-ERUS) with magnification chromoendoscopy (MCE) regarding their accuracy in assessing parietal invasion depth (T).MethodsPatients with middle and distal rectum neoplasms were prospectively included. Two providers blinded to each other's assessment performed 3D-ERUS and MCE, respectively. The T stage assessed through ERUS was compared to the MCE evaluation. The results were compared to the surgical specimen anatomopathological report. Sensitivity, specificity, accuracy, positive (PPV), and negative (NPV) predictive values were calculated for the T stage and for the final therapy (local excision or radical surgery).ResultsIn 8 years, 70 patients were enrolled, and all underwent both exams. MCE and ERUS showed an accuracy of 94.3% and 85.7%, sensitivity of 83.7 and 93.3%, specificity of 96.4 and 83.6%, PPV of 86.7 and 60.9%, and NPV of 96.4 and 97.9%, respectively. Kappa for T stage assessed through ERUS was 0.64 and 0.83 for MCE.ConclusionMCE and 3D-ERUS had good diagnostic performance, but the endoscopic method had higher accuracy. Both methods reliably assessed lesion extension, circumferential involvement, and distance from the anal verge.
  • article 0 Citação(ões) na Scopus
    Rectal gist resection following neoadjuvant therapy. Reporting two cases from a single institute [Resección del gist rectal tras la terapia neo-adyuvante. Relato de dos casos de un único instituto]
    (2020) PANDINI, R.V.; JúNIOR, S.S.; PINTO, R.A.; NAHAS, C.S.R.; TUSTUMI, F.; PINHEIRO, R.B.B.; JúNIOR, U.R.; NAHAS, S.C.; CECCONELLO, I.
    Gastrointestinal stromal tumours (GIST) are the most common neoplasms arising from the mesenchymal cells of the gastrointestinal tract. Although GIST can arise in any gastrointestinal site, the most common are stomach and small bowel. Less than 5% of all GIST are located in rectum. Surgery is the main treatment option for resectable GIST. Current-ly, local excision has been increasingly employed thanks to neoadjuvant therapy. This paper reports two cases of rectal GIST treated with Imatinib neoadjuvant therapy followed by trans anal local resection. © 2020, Sociedad Argentina de Gastroenterologia. All rights reserved.
  • article 1 Citação(ões) na Scopus
    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 Carlos
    Background: 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.