RODRIGO AMBAR PINTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
11 resultados
Resultados de Busca
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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.- 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, IvanABSTRACT 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.
- Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?(2017) CORREA NETO, Isaac Jose Felippe; PINTO, Rodrigo Ambar; JORGE, Jose Marcio Neves; SANTO, Marco Aurelio; BUSTAMANTE-LOPEZ, Leonardo Alfonso; CECCONELLO, Ivan; NAHAS, Sergio CarlosFactors associated with increased intra-abdominal pressure such as chronic cough, morbid obesity, and constipation may be related to pelvic floor dysfunction. In this study, we compared anorectal manometry values and clinical data of class II and III morbidly obese patients referred to bariatric surgery with that of non-obese patients. We performed a case-matched study between obese patients referred to bariatric surgery and non-obese patients without anorectal complaints. The groups were matched by age and gender. Men and nulliparous women with no history of abdominal or anorectal surgery were included in the study. Anorectal manometry was performed by the stationary technique, and clinical evaluation was based on validated questionnaires. Mean age was 44.8 +/- 12.5 years (mean +/- SD) in the obese group and 44.1 +/- 11.8 years in the non-obese group (p = 0.829). In the obese group, 65.4% of patients had some degree of fecal incontinence. Mean squeeze pressure was significantly lower in obese than in non-obese patients (155.6 +/- 64.1 vs. 210.1 +/- 75.9 mmHg, p = 0.004), and there was no significant difference regarding mean rest pressure in obese patients compared to non-obese ones (63.7 +/- 23.1 vs. 74.1 +/- 21.8 mmHg, p = 0.051). There were no significant differences in anorectal manometry values between continent and incontinent obese patients. The prevalence of fecal incontinence among obese patients was high regardless of age, gender, and body mass index. Anal squeeze pressure was significantly lower in obese patients compared to non-obese controls.
conferenceObject DOES THE TYPE OF FIXATIVE SOLUTION CORRELATE TO LYMPH NODE YIELD IN LEFT COLON CANCER? A RANDOMIZED TRIAL COMPARING FORMALIN AND CARNOY.(2017) DIAS, A.; PINTO, R.; PEREIRA, M.; CAMARGO, M.; SOUSA, J.; MELLO, E.; NAHAS, S.; CECCONELLO, I.; RIBEIRO JUNIOR, U.- Efficacy of 3-Dimensional Endorectal Ultrasound for Staging Early Extraperitoneal Rectal Neoplasms(2017) PINTO, Rodrigo Ambar; CORREA NETO, Isaac Jose Felippe; NAHAS, Sergio Carlos; NAHAS, Caio Sergio Rizkalah; MARQUES, Carlos Frederico Sparapan; RIBEIRO JUNIOR, Ulysses; KAWAGUTI, Fabio Shiguehissa; CECCONELLO, IvanBACKGROUND: Adequate oncologic staging of rectal neoplasia is important for treatment and prognostic evaluation of the disease. Diagnostic methods such as endorectal ultrasound can assess rectal wall invasion and lymph node involvement. OBJECTIVE: The purpose of this study was to correlate findings of 3-dimensional endorectal ultrasound and pathologic diagnosis of extraperitoneal rectal tumors with regard to depth of rectal wall invasion, lymph node involvement, percentage of rectal circumference involvement, and tumor extension. DESIGN: Consecutive patients with extraperitoneal rectal tumors were prospectively assessed by 3-dimensional endorectal ultrasound blind to other staging methods and pathologic diagnosis. PATIENTS: Patients who underwent endorectal ultrasound followed by surgery were included in the study. SETTINGS: The study was conducted at a single academic institution. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values, area under curve, and. coefficient between 3-dimensional endorectal ultrasound and pathologic diagnosis were determined. Intraclass correlation coefficient was calculated for tumor extension and percentage of rectal wall involvement. RESULTS: Forty-four patients (27 women; mean age = 63.5 years) were evaluated between September 2010 and June 2014. Most lesions were malignant (72.7%). For depth of submucosal invasion, 3-dimensional endorectal ultrasound showed sensitivity of 77.3%, specificity of 86.4%, positive predictive value of 85.0%, a negative predictive value of 79.2%, and an area under curve of 0.82. The weighted. coefficient for depth of rectal wall invasion staging was 0.67, and there was no agreement between 3-dimensional endorectal ultrasound and pathologic diagnosis for lymph node involvement (kappa = -0.164). Intraclass correlation coefficient for lesion extension and percentage of rectal circumference involvement were 0.45 and 0.66. A better correlation between 3-dimensional endorectal ultrasound and pathologic diagnosis was observed in tumors <5 cm and with <50% of rectal wall involvement. LIMITATIONS: The relatively small sample size of patients with early rectal lesions referred directly for surgery could represent a potential selection bias. CONCLUSIONS: Three-dimensional endorectal ultrasound was effective for determining rectal wall invasion and lesion extension in tumors <5 cm and with <50% of rectal wall invasion but was limited for detecting lymph node involvement in early rectal lesions.
bookPart Cirurgia paliativa(2017) PINTO, Rodrigo Ambar; CORREA NETO, Isaac José Felippe; D'ALESSANDRO, Maria Perez Soares- Prognostic factors affecting outcomes in multivisceral en bloc resection for colorectal cancer(2017) NAHAS, Caio Sergio Rizkallah; NAHAS, Sergio Carlos; RIBEIRO-JUNIOR, Ulysses; BUSTAMANTE-LOPEZ, Leonardo; MARQUES, Carlos Frederico Sparapan; PINTO, Rodrigo Ambar; IMPERIALE, Antonio Rocco; COTTI, Guilherme Cutait; NAHAS, William Carlos; CHADE, Daher Cezar; PIATO, Dariane Sampaio; BUSNARDO, Fabio; CECCONELLO, IvanOBJECTIVES: This study sought to determine the clinical and pathological factors associated with perioperative morbidity, mortality and oncological outcomes after multivisceral en bloc resection in patients with colorectal cancer. METHODS: Between January 2009 and February 2014, 105 patients with primary colorectal cancer selected for multivisceral resection were identified from a prospective database. Clinical and pathological factors, perioperative morbidity and mortality and outcomes were obtained from medical records. Estimated local recurrence and overall survival were compared using the log-rank method, and Cox regression analysis was used to determine the independence of the studied parameters. ClinicalTrials.gov: NCT02859155. RESULTS: The median age of the patients was 60 (range 23-86) years, 66.7% were female, 80% of tumors were located in the rectum, 11.4% had stage-IV disease, and 54.3% received neoadjuvant chemoradiotherapy. The organs most frequently resected were ovaries and annexes (37%). Additionally, 30.5% of patients received abdominoperineal resection. Invasion of other organs was confirmed histologically in 53.5% of patients, and R0 resection was obtained in 72% of patients. The overall morbidity rate of patients in this study was 37.1%. Ureter resection and intraoperative blood transfusion were independently associated with an increased number of complications. The 30-day postoperative mortality rate was 1.9%. After 27 (range 5-57) months of follow-up, the mortality and local recurrence rates were 23% and 15%, respectively. Positive margins were associated with a higher recurrence rate. Positive margins, lymph node involvement, stage III/IV disease, and stage IV disease alone were associated with lower overall survival rates. On multivariate analysis, the only factor associated with reduced survival was lymph node involvement. CONCLUSIONS: Multivisceral en bloc resection for primary colorectal cancer can be performed with acceptable rates of morbidity and mortality and may lead to favorable oncological outcomes.
conferenceObject PATIENTS WITH DISTAL RECTAL CANCER: OUTCOMES TO CHOOSE TREATMENT STRATEGY FOR PATIENTS WITH LOW RECTAL CANCER.(2017) NAHAS, S.; BUSTAMANTE-LOPEZ, L.; PINTO, R.; NAHAS, C.; MARQUES, C.; CAMPOS, F.; CECCONELLO, I.conferenceObject EFFICACY OF BIOFEEDBACK ASSOCIATED TO ELECTRO-STIMULATION FOR FECAL INCONTINENCE: A PILOT STUDY IN A UNIVERSITY HOSPITAL IN BRAZIL.(2017) PINTO, R.; BATISTA, P.; BRANDAO, D.; TANAKA, C.; CORREA NETO, I.; BUSTAMANTE-LOPEZ, L.; CAMARGO, M.; CECCONELLO, I.; NAHAS, S.