11 results on '"Roberto A. Rocha"'
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2. BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT
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Leandro Cardoso BARCHI, Marcus Fernando Kodama Pertille RAMOS, André Roncon DIAS, Nora Manoukian FORONES, Marineide Prudêncio de CARVALHO, Osvaldo Antonio Prado CASTRO, Paulo KASSAB, Wilson Luiz da COSTA-JÚNIOR, Antônio Carlos WESTON, Bruno ZILBERSTEIN, Álvaro Antônio Bandeira Ferraz, Amir ZeideCharruf, André Brandalise, André Maciel da Silva, Barlon Alves, Carlos Augusto Martinez Marins, Carlos Alberto Malheiros, Celso Vieira Leite, Claudio José Caldas Bresciani, Daniel Szor, Donato Roberto Mucerino, Durval R. Wohnrath, Elias JirjossIlias, Euclides Dias Martins Filho, Fabio PinatelLopasso, Felipe José Fernandez Coimbra, Fernando E. Cruz Felippe, Flávio Daniel Saavedra Tomasisch, Flavio Roberto Takeda, Geraldo Ishak, Gustavo Andreazza Laporte, Herbeth José Toledo Silva, Ivan Cecconello, Joaquim José Gama Rodrigues, José Carlos Del Grande, Laércio Gomes Lourenço, Leonardo Milhomem da Motta, Leonardo Rocha Ferraz, Luis Fernando Moreira, Luis Roberto Lopes, Marcelo Garcia Toneto, Marcelo Mester, Marco Antônio Gonçalves Rodrigues, Maurice Youssef Franciss, Nelson AdamiAndreollo, Oly Campos Corletta, Osmar Kenji Yagi, Osvaldo Malafaia, Paulo Pimentel Assumpção, Paulo Roberto Savassi-Rocha, Ramiro Colleoni Neto, Rodrigo Jose de Oliveira, Rubens Antonio AissarSallun, Rui Weschenfelder, Saint Clair Vieira de Oliveira, Thiago Boechat de Abreu, Tiago Biachi de Castria, Ulysses Ribeiro Junior, Williams Barra, and Wilson Rodrigues de Freitas Júnior
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Gastric cancer ,Practice cuideline ,Gastrectomy ,Lymphadenectomy ,Combined modality therapy ,Consensus ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.
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- 2021
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- View/download PDF
3. BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP
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Leandro Cardoso BARCHI, Marcus Fernando Kodama Pertille RAMOS, Osmar Kenji YAGI, Donato Roberto MUCERINO, Claudio José Caldas BRESCIANI, Ulysses RIBEIRO JÚNIOR, Nelson Adami ANDREOLLO, Paulo Pimentel ASSUMPÇÃO, Antônio Carlos WESTON, Ramiro COLLEONI NETO, Bruno ZILBERSTEIN, Álvaro Antônio Bandeira Ferraz, Amir Zeide Charruf, André Roncon Dias, André Brandalise, André Maciel da Silva, Barlon Alves, Carlos Alberto Malheiros, Carlos Augusto Martinez Marins, Celso Vieira Leite, Daniel Szor, Durval R. Wohnrath, Elias Jirjoss Ilias, Euclides Dias Martins Filho, Fabio Pinatel Lopasso, Felipe José Fernandez Coimbra, Fernando E. Cruz Felippe, Flávio Daniel Saavedra Tomasisch, Flavio Roberto Takeda, Geraldo Ishak, Gustavo Andreazza Laporte, Herbeth José Toledo Silva, Ivan Cecconello, Joaquim José Gama Rodrigues, José Carlos Del Grande, Laércio Gomes Lourenço, Leonardo Milhomem da Motta, Leonardo Rocha Ferraz, Luis Fernando Moreira, Luis Roberto Lopes, Marcelo Garcia Toneto, Marcelo Mester, Marco Antônio Gonçalves Rodrigues, Marineide Prudêncio de Carvalho, Maurice Youssef Franciss, Nora Manoukian Forones, Oly Campos Corletta, Osvaldo Antonio Prado Castro, Osvaldo Malafaia, Paulo Kassab, Paulo Roberto Savassi-Rocha, Rodrigo Jose de Oliveira, Rubens Antonio Aissar Sallun, Rui Weschenfelder, Saint Clair Vieira de Oliveira, Thiago Boechat de Abreu, Tiago Biachi de Castria, Williams Barra, Wilson Luiz da Costa Júnior, and Wilson Rodrigues de Freitas Júnior
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Gastric cancer ,Guidelines ,Staging ,Endoscopic treatment ,Consensus ,Follow-up ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ABSTRACT Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.
- Published
- 2020
- Full Text
- View/download PDF
4. II BRAZILIAN CONSENSUS ON GASTRIC CANCER BY THE BRAZILIAN GASTRIC CANCER ASSOCIATION
- Author
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Leandro Cardoso BARCHI, Marcus Fernando Kodama Pertille RAMOS, André Roncon DIAS, Nelson Adami ANDREOLLO, Antônio Carlos WESTON, Laércio Gomes LOURENÇO, Carlos Alberto MALHEIROS, Paulo KASSAB, Bruno ZILBERSTEIN, Álvaro Antônio Bandeira Ferraz, Amir Zeide Charruf, André Brandalise, André Maciel da Silva, Barlon Alves, Carlos Augusto Martinez Marins, Celso Vieira Leite, Claudio José Caldas Bresciani, Daniel Szor, Donato Roberto Mucerino, Durval R. Wohnrath, Elias Jirjoss Ilias, Euclides Dias Martins Filho, Fabio Pinatel Lopasso, Felipe José Fernandez Coimbra, Fernando E. Cruz Felippe, Flávio Daniel Saavedra Tomasisch, Flavio Roberto Takeda, Geraldo Ishak, Gustavo Andreazza Laporte, Herbeth José Toledo Silva, Ivan Cecconello, Joaquim José Gama Rodrigues, José Carlos Del Grande, Leonardo Milhomem da Motta, Leonardo Rocha Ferraz, Luis Fernando Moreira, Luis Roberto Lopes, Marcelo Garcia Toneto, Marcelo Mester, Marco Antônio Gonçalves Rodrigues, Marineide Prudêncio de Carvalho, Maurice Youssef Franciss, Nora Manoukian Forones, Oly Campos Corletta, Osmar Kenji Yagi, Osvaldo Antonio Prado Castro, Osvaldo Malafaia, Paulo Pimentel Assumpção, Paulo Roberto Savassi-Rocha, Ramiro Colleoni Neto, Rodrigo Jose de Oliveira, Rubens Antonio Aissar Sallun, Rui Weschenfelder, Saint Clair Vieira de Oliveira, Thiago Boechat de Abreu, Tiago Biachi de Castria, Ulysses Ribeiro Junior, Williams Barra, Wilson Luiz da Costa Júnior, and Wilson Rodrigues de Freitas Júnior
- Subjects
Gastric neoplasms ,Gastric cancer ,Gastrectomy ,Lymphadenectomy ,Consensus ,Adenocarcinoma ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ABSTRACT Background: Since the publication of the first Brazilian Consensus on Gastric Cancer (GC) in 2012 carried out by the Brazilian Gastric Cancer Association, new concepts on diagnosis, staging, treatment and follow-up have been incorporated. Aim: This new consensus is to promote an update to professionals working in the fight against GC and to provide guidelines for the management of patients with this condition. Methods: Fifty-nine experts answered 67 statements regarding the diagnosis, staging, treatment and prognosis of GC with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. This article presents only the responses of the participating experts. Comments on each statement, as well as a literature review, will be presented in future publications. Results: Of the 67 statements, there was consensus in 50 (74%). In 10 declarations, there was 100% agreement. Conclusion: The gastric cancer treatment has evolved considerably in recent years. This consensus gathers consolidated principles in the last decades, new knowledge acquired recently, as well as promising perspectives on the management of this disease.
- Published
- 2020
- Full Text
- View/download PDF
5. Lesão de isquemia e reperfusão após clampagem contínua ou intermitente do pedículo hepático em coelhos Ischemia/reperfusion injury after continuous or intermittent hepatic pedicle clamping in rabbits
- Author
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André Luis Ramires Seabra, Paulo Roberto Savassi-Rocha, Anilton César Vasconcelos, Agnaldo Soares Lima, Kelly Cristine Lacerda Rodrigues, and Herbert Motta de Almeida
- Subjects
Isquemia ,Traumatismo por reperfusão ,Fígado ,Apoptose ,Ischemia ,Reperfusion injury ,Liver ,Apoptosis ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
RACIONAL: O controle do sangramento na hepatectomia é um desafio para os cirurgiões. A clampagem do pedículo hepático é manobra cirúrgica que pode promover redução do sangramento, mas provoca isquemia hepatocelular. Isso, junto com a reperfusão depois que a clampagem termina, leva à lesão de isquemia e reperfusão. OBJETIVO: Examinar os efeitos da lesão de isquemia e reperfusão no fígado após clampagem contínua e intermitente do pedículo hepático, usando a quantificação de apoptose como ferramenta. MÉTODO: Vinte coelhos New Zealand foram divididos em grupos 1 (controle), 2 (60 minutos de isquemia contínua) e 3 (60 minutos de isquemia intermitente alternando 12 minutos de isquemia e três minutos de reperfusão). Biópsias hepáticas foram colhidas antes e ao fim da isquemia e após seis horas de reperfusão, quando os animais eram sacrificados. Os fragmentos obtidos foram submetidos à análise histológica e histoquímica (reação de Tunel). Campos microscópicos foram analisados para caracterização e quantificação de apoptose. RESULTADOS: A isquemia levou à elevação do índice apoptótico em ambos os grupos experimentais em relação aos controles, mas similar entre eles. Depois da reperfusão os índices voltaram aos valores iniciais. CONCLUSÃO: A clampagem do pedículo hepático, tanto contínua quanto intermitente, induz a apoptose em células hepáticas de modo igual.BACKGROUND : The control of bleeding in hepatectomy is a challenge for surgeons. The hepatic pedicle clamping is a surgical maneuver that can provide reduction in bleeding, but it provokes a hepatocellular suffering. This, along with reperfusion after the clamping finishes, leads to an injury known as ischemia/reperfusion injury. AIM: To examine the effects of the ischemia/reperfusion injury on the liver after continuous and intermittent hepatic pedicle clamping in an animal model, using the quantification of apoptosis for evaluation. METHOD: Twenty New Zealand rabbits were assigned to groups 1 (control), 2 (60 minutes of continuous ischemia) and 3 (60 minutes of intermittent ischemia alternating 12 minutes of ischemia and three minutes of reperfusion). Liver biopsies were collected before ischemia, at its end and after six hours of reperfusion, when the animals were killed. The liver fragments were subjected to histological analysis (paraffinization and hematoxilin-eosin staining) and histochemical (Tunel reaction). Microscope fields of view were scanned for characterization and quantification of apoptosis. RESULTS : Ischemia led to an increased apoptotic index in both experimental groups in comparison to controls, but similarly between them. After the reperfusion, the indexes returned to baseline values. CONCLUSION: Clamping of the hepatic pedicle, either continuous or intermittent, induces apoptosis in liver cells in a similar way.
- Published
- 2012
6. Ligadura simples ou ligadura com confecção de bolsa e sepultamento para tratamento do coto apendicular: estudo comparativo prospecivo randomizado Simple ligation or ligation and purse string invagination for the treatment of the appendiceal stump: a prospective, randomized trial
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Lauro José Victor Avellán Neves, Alberto Julius Alves Wainstein, Wallace Ceoto Mathias, Fabrizio Parreira Dias Costa, Judson Henrique de Castro, and Paulo Roberto Avassi-Rocha
- Subjects
Apendicectomia ,Apendicite ,Procedimentos cirúrgicos operatórios ,Ensaio clínico controlado aleatório ,Appendectomy ,Appendicitis ,Surgical procedures, operative ,Randomized controlled trial ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
RACIONAL: Apesar da apendicite aguda ser uma das afecções cirúrgicas mais comuns, o melhor tratamento do coto apendicular ainda não foi definido. Na apendicectomia laparotômica há preferência pela ligadura e sepultamento do coto enquanto, na laparoscópica, pela ligadura simples ou clampeamento. OBJETIVOS: Comparar duas técnicas de tratamento do coto apendicular na apendicectomia laparotômica (ligadura simples vs ligadura com confecção de bolsa e sepultamento) por meio de análise prospectiva e randomizada. MÉTODOS: Entre os anos de 2003 e 2005, 113 pacientes foram submetidos à apendicectomia laparotômica por apendicite aguda. O coto apendicular foi tratado por ligadura simples em 49 casos e por ligadura e sepultamento em 64 casos. Os dois grupos foram semelhantes em relação às médias de idade, gênero, sinais e sintomas pré-operatórios, tempo de evolução da doença e fase da apendicite aguda diagnosticada pelo exame anatomopatológico. RESULTADOS: Não houve diferença estatística significativa entre os dois grupos em relação ao tempo de duração da operação, presença de complicações (infecção de ferida operatória, deiscência de ferida, formação de abscessos, obstrução intestinal, seroma e formação de fístula) ou tempo de internação. CONCLUSÃO: As duas técnicas são igualmente seguras para tratamento do coto apendicular.BACKGROUND: Although acute appendicitis is one of the most common surgical diseases, the best treatment of the appendicular stump has not been defined. At laparotomy for appendectomy the stump is treated preferably by ligation and burial of the stump and, in laparoscopic surgery, by simple ligation or clamping. AIM: To compare two techniques for the treatment of appendicular stump in appendectomy (simple ligation vs ligation with purse making and burial) by a prospective and randomized study. METHODS: Between the years 2003 and 2005, 113 patients underwent laparotomy appendectomy for acute appendicitis. The appendiceal stump was treated by simple ligation in 49 cases and by ligation and burial in 64 cases. The two groups were similar in terms of average age, gender, preoperative signs and symptoms, time of disease progression and stage of appendicitis diagnosed histopathological examination. RESULTS: There was no statistically significant difference between the two groups regarding the duration of operation, complications (wound infection, wound dehiscence, abscess formation, intestinal obstruction, fistula and seroma ) or hospital stay. CONCLUSIONS: Both techniques are equally safe for treatment of appendicular stump, and so, it is possible to recommend simple ligation because it is easier to be done.
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- 2011
- Full Text
- View/download PDF
7. II BRAZILIAN CONSENSUS ON GASTRIC CANCER BY THE BRAZILIAN GASTRIC CANCER ASSOCIATION
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Tiago Biachi de Castria, Marcus Fernando Kodama Pertille Ramos, Laércio Gomes Lourenço, Oly Campos Corletta, Daniel Jose Szor, Paulo Kassab, José Carlos Del Grande, Rubens Antonio Aissar Sallun, Leonardo Rocha Ferraz, Herbeth José Toledo Silva, Flávio Daniel Saavedra Tomasisch, Marineide Prudêncio de Carvalho, Rodrigo Jose de Oliveira, Gustavo Andreazza Laporte, Osmar Kenji Yagi, Luis Fernando Moreira, Elias Jirjoss Ilias, Nelson Adami Andreollo, Antonio Carlos Weston, Carlos Alberto Malheiros, Fernando E. Cruz Felippe, André Brandalise, Álvaro Antônio Bandeira Ferraz, Luis Roberto Lopes, Geraldo Ishak, André Maciel da Silva, Paulo Pimentel Assumpção, Maurice Franciss, Wilson Luiz da Costa Junior, Nora Manoukian Forones, Donato Roberto Mucerino, Ivan Cecconello, Williams Barra, Fabio Pinatel Lopasso, Joaquim José Gama Rodrigues, Saint Clair Vieira de Oliveira, Flavio Roberto Takeda, Thiago Boechat de Abreu, Celso Vieira de Souza Leite, Marco Antônio Gonçalves Rodrigues, Barlon Alves, Amir Zeide Charruf, Ulysses Ribeiro Junior, Rui Weschenfelder, Bruno Zilberstein, Ramiro Colleoni Neto, Marcelo Garcia Toneto, Felipe José Fernandez Coimbra, Wilson Rodrigues de Freitas Junior, Osvaldo Malafaia, Andre Roncon Dias, Leonardo Milhomem da Motta, Cláudio José Caldas Bresciani, Durval R. Wohnrath, Marcelo Mester, Euclides Dias Martins Filho, Osvaldo Antonio Prado Castro, Paulo Roberto Savassi-Rocha, Carlos Augusto Martinez Marins, and Leandro Cardoso Barchi
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medicine.medical_specialty ,Neoplasias gástricas ,Consensus ,RD1-811 ,medicine.medical_treatment ,Disease ,RC799-869 ,Adenocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,Stomach Neoplasms ,Gastrectomy ,Medicine ,Humans ,Association (psychology) ,Societies, Medical ,Gastrectomia ,business.industry ,Cancer ,Lymphadenectomy ,General Medicine ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Cancer treatment ,Gastric neoplasms ,Consenso ,030220 oncology & carcinogenesis ,Family medicine ,Linfadenectomia ,030211 gastroenterology & hepatology ,Original Article ,Surgery ,Câncer gástrico ,business ,Gastric cancer ,Gastric Neoplasm ,Brazil - Abstract
Background: Since the publication of the first Brazilian Consensus on Gastric Cancer (GC) in 2012 carried out by the Brazilian Gastric Cancer Association, new concepts on diagnosis, staging, treatment and follow-up have been incorporated. Aim: This new consensus is to promote an update to professionals working in the fight against GC and to provide guidelines for the management of patients with this condition. Methods: Fifty-nine experts answered 67 statements regarding the diagnosis, staging, treatment and prognosis of GC with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. This article presents only the responses of the participating experts. Comments on each statement, as well as a literature review, will be presented in future publications. Results: Of the 67 statements, there was consensus in 50 (74%). In 10 declarations, there was 100% agreement. Conclusion: The gastric cancer treatment has evolved considerably in recent years. This consensus gathers consolidated principles in the last decades, new knowledge acquired recently, as well as promising perspectives on the management of this disease.
- Published
- 2020
8. BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP
- Author
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Rubens Antonio Aissar Sallun, Marco Antônio Gonçalves Rodrigues, Marineide Prudêncio de Carvalho, Paulo Roberto Savassi-Rocha, Donato Roberto Mucerino, Bruno Zilberstein, Herbeth José Toledo Silva, Flávio Daniel Saavedra Tomasisch, Osmar Kenji Yagi, Joaquim José Gama Rodrigues, Euclides Dias Martins Filho, Rodrigo Jose de Oliveira, Saint Clair Vieira de Oliveira, José Carlos Del Grande, Carlos Alberto Malheiros, Gustavo Andreazza Laporte, Carlos Augusto Martinez Marins, Ivan Cecconello, Osvaldo Antonio Prado Castro, Nora Manoukian Forones, Leandro Cardoso Barchi, Amir Zeide Charruf, Flavio Roberto Takeda, Leonardo Rocha Ferraz, Rui Weschenfelder, Cláudio José Caldas Bresciani, Celso Vieira de Souza Leite, Luis Roberto Lopes, André Brandalise, André Maciel da Silva, Álvaro Antônio Bandeira Ferraz, Paulo Pimentel Assumpção, Durval R. Wohnrath, Fabio Pinatel Lopasso, Barlon Alves, Geraldo Ishak, Antonio Carlos Weston, Marcus Fernando Kodama Pertille Ramos, Elias Jirjoss Ilias, Daniel Jose Szor, Fernando E. Cruz Felippe, Maurice Franciss, Wilson Luiz da Costa Junior, Williams Barra, Osvaldo Malafaia, Ulysses Ribeiro Junior, Leonardo Milhomem da Motta, Marcelo Mester, Ramiro Colleoni Neto, Marcelo Garcia Toneto, Felipe José Fernandez Coimbra, Luis Fernando Moreira, Nelson Adami Andreollo, Laércio Gomes Lourenço, Wilson Rodrigues de Freitas Junior, Thiago Boechat de Abreu, Andre Roncon Dias, Tiago Biachi de Castria, Oly Campos Corletta, and Paulo Kassab
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Staging ,Consensus ,RD1-811 ,Seguimento ,RC799-869 ,Guidelines ,03 medical and health sciences ,0302 clinical medicine ,Stomach Neoplasms ,Humans ,Endoscopy, Digestive System ,Neoplasm Staging ,Follow-up ,Estadiamento ,Endoscopic treatment ,General Medicine ,Diseases of the digestive system. Gastroenterology ,Diretriz ,Consenso ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Original Article ,Câncer gástrico ,Tratamento endoscópico ,Gastric cancer ,Brazil ,Follow-Up Studies - Abstract
Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice. RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico (ABCG) foi recentemente publicado. Nesta ocasião, inúmeros especialistas que atuam no tratamento desta doença expressaram sua opinião diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 1) quanto ao diagnóstico, estadiamento, tratamento endoscópico e seguimento dos pacientes com câncer gástrico. Métodos: Para formulação destas Diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO com os seguintes descritores: câncer gástrico, estadiamento, tratamento endoscópico e seguimento. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 24 declarações, duas (8,3%) foram classificadas com nível de evidência A, 11 (45,8%) B e 11 (45,8%) C. Quanto ao grau de recomendação, seis (25%) declarações obtiveram grau de recomendação 1, nove (37,5%) grau 2a, seis (25%) 2b e três (12,5%) 3. Conclusão: As diretrizes aqui presentes têm a finalidade de auxiliar os profissionais que atuam no combate ao câncer gástrico com informações relevantes e atuais, permitindo que sejam aplicadas na prática médica diária.
- Published
- 2020
9. Lesão de isquemia e reperfusão após clampagem contínua ou intermitente do pedículo hepático em coelhos
- Author
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Paulo Roberto Savassi-Rocha, Anilton Cesar Vasconcelos, André Luis Ramires Seabra, Agnaldo Soares Lima, Kelly Cristine de Lacerda Rodrigues, and Herbert Motta de Almeida
- Subjects
Baseline values ,Isquemia/Cirurgia ,TUNEL assay ,business.industry ,Apoptose ,medicine.medical_treatment ,Ischemia ,Apoptosis ,Fígado/cirurgia ,General Medicine ,medicine.disease ,Clamping ,Isquemia ,Reperfusion injury ,Animal model ,Traumatismo por reperfusão ,Fígado ,Liver ,Anesthesia ,medicine ,Hepatectomy ,business - Abstract
RACIONAL: O controle do sangramento na hepatectomia é um desafio para os cirurgiões. A clampagem do pedículo hepático é manobra cirúrgica que pode promover redução do sangramento, mas provoca isquemia hepatocelular. Isso, junto com a reperfusão depois que a clampagem termina, leva à lesão de isquemia e reperfusão. OBJETIVO: Examinar os efeitos da lesão de isquemia e reperfusão no fígado após clampagem contínua e intermitente do pedículo hepático, usando a quantificação de apoptose como ferramenta. MÉTODO: Vinte coelhos New Zealand foram divididos em grupos 1 (controle), 2 (60 minutos de isquemia contínua) e 3 (60 minutos de isquemia intermitente alternando 12 minutos de isquemia e três minutos de reperfusão). Biópsias hepáticas foram colhidas antes e ao fim da isquemia e após seis horas de reperfusão, quando os animais eram sacrificados. Os fragmentos obtidos foram submetidos à análise histológica e histoquímica (reação de Tunel). Campos microscópicos foram analisados para caracterização e quantificação de apoptose. RESULTADOS: A isquemia levou à elevação do índice apoptótico em ambos os grupos experimentais em relação aos controles, mas similar entre eles. Depois da reperfusão os índices voltaram aos valores iniciais. CONCLUSÃO: A clampagem do pedículo hepático, tanto contínua quanto intermitente, induz a apoptose em células hepáticas de modo igual. BACKGROUND : The control of bleeding in hepatectomy is a challenge for surgeons. The hepatic pedicle clamping is a surgical maneuver that can provide reduction in bleeding, but it provokes a hepatocellular suffering. This, along with reperfusion after the clamping finishes, leads to an injury known as ischemia/reperfusion injury. AIM: To examine the effects of the ischemia/reperfusion injury on the liver after continuous and intermittent hepatic pedicle clamping in an animal model, using the quantification of apoptosis for evaluation. METHOD: Twenty New Zealand rabbits were assigned to groups 1 (control), 2 (60 minutes of continuous ischemia) and 3 (60 minutes of intermittent ischemia alternating 12 minutes of ischemia and three minutes of reperfusion). Liver biopsies were collected before ischemia, at its end and after six hours of reperfusion, when the animals were killed. The liver fragments were subjected to histological analysis (paraffinization and hematoxilin-eosin staining) and histochemical (Tunel reaction). Microscope fields of view were scanned for characterization and quantification of apoptosis. RESULTS : Ischemia led to an increased apoptotic index in both experimental groups in comparison to controls, but similarly between them. After the reperfusion, the indexes returned to baseline values. CONCLUSION: Clamping of the hepatic pedicle, either continuous or intermittent, induces apoptosis in liver cells in a similar way.
- Published
- 2012
10. Ligadura simples ou ligadura com confecção de bolsa e sepultamento para tratamento do coto apendicular: estudo comparativo prospecivo randomizado
- Author
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Judson Henrique de Castro, Fabrizio Parreira Dias Costa, Wallace Ceoto Mathias, Lauro José Victor Avellán Neves, Alberto Julius Alves Wainstein, and Paulo Roberto Avassi-Rocha
- Subjects
Surgical procedures, operative ,Randomized controlled trial ,Procedimentos cirúrgicos operatórios ,Appendectomy ,General Medicine ,Appendicitis ,Apendicectomia ,Apendicite ,Ensaio clínico controlado aleatório - Abstract
RACIONAL: Apesar da apendicite aguda ser uma das afecções cirúrgicas mais comuns, o melhor tratamento do coto apendicular ainda não foi definido. Na apendicectomia laparotômica há preferência pela ligadura e sepultamento do coto enquanto, na laparoscópica, pela ligadura simples ou clampeamento. OBJETIVOS: Comparar duas técnicas de tratamento do coto apendicular na apendicectomia laparotômica (ligadura simples vs ligadura com confecção de bolsa e sepultamento) por meio de análise prospectiva e randomizada. MÉTODOS: Entre os anos de 2003 e 2005, 113 pacientes foram submetidos à apendicectomia laparotômica por apendicite aguda. O coto apendicular foi tratado por ligadura simples em 49 casos e por ligadura e sepultamento em 64 casos. Os dois grupos foram semelhantes em relação às médias de idade, gênero, sinais e sintomas pré-operatórios, tempo de evolução da doença e fase da apendicite aguda diagnosticada pelo exame anatomopatológico. RESULTADOS: Não houve diferença estatística significativa entre os dois grupos em relação ao tempo de duração da operação, presença de complicações (infecção de ferida operatória, deiscência de ferida, formação de abscessos, obstrução intestinal, seroma e formação de fístula) ou tempo de internação. CONCLUSÃO: As duas técnicas são igualmente seguras para tratamento do coto apendicular. BACKGROUND: Although acute appendicitis is one of the most common surgical diseases, the best treatment of the appendicular stump has not been defined. At laparotomy for appendectomy the stump is treated preferably by ligation and burial of the stump and, in laparoscopic surgery, by simple ligation or clamping. AIM: To compare two techniques for the treatment of appendicular stump in appendectomy (simple ligation vs ligation with purse making and burial) by a prospective and randomized study. METHODS: Between the years 2003 and 2005, 113 patients underwent laparotomy appendectomy for acute appendicitis. The appendiceal stump was treated by simple ligation in 49 cases and by ligation and burial in 64 cases. The two groups were similar in terms of average age, gender, preoperative signs and symptoms, time of disease progression and stage of appendicitis diagnosed histopathological examination. RESULTS: There was no statistically significant difference between the two groups regarding the duration of operation, complications (wound infection, wound dehiscence, abscess formation, intestinal obstruction, fistula and seroma ) or hospital stay. CONCLUSIONS: Both techniques are equally safe for treatment of appendicular stump, and so, it is possible to recommend simple ligation because it is easier to be done.
- Published
- 2011
11. PRE-OPERATIVE GASTRIC GIST DOWNSIZING: THE IMPORTANCE OF NEOADJUVANT THERAPY
- Author
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João Bernardo Sancio Rocha RODRIGUES, Renato Gomes CAMPANATI, Francisco NOLASCO, Athos Miranda BERNARDES, Soraya Rodrigues de Almeida SANCHES, and Paulo Roberto SAVASSI-ROCHA
- Subjects
Gastrointestinal stromal tumor ,Neoadjuvant therap ,Imatinib Mesylat ,Molecular targeted therap ,Chemotherapy, adjuvan ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ABSTRACT Introduction: Gastric gastrointestinal tumors (GIST) are a rare and usually asymptomatic neoplasm that can present as abdominal mass in more advanced scenarios. Since surgical resection is the main aspect of the treatment, locally advanced tumors require multivisceral resection and, therefore, higher postoperative morbidity and mortality. Objective: To perform a review the literature on the topic, with emphasis on the neoadjuvant therapy. Methods: Literature review on the Medline database using the following descriptors: gastrointestinal stromal tumors, neoadjuvant therapy, imatinib mesylate and molecular targeted therapy. Results: Surgical resection remains the cornerstone for the treatment of GISTs; however, tyrosine kinase inhibitors have improved survival as an adjuvant therapy. More recently, neoadjuvant therapy have been described in the treatment of locally advanced tumors in order to avoid multivisceral resection. Conclusion: Despite surgical resection remains as the most important aspect of the treatment of GISTs, adjuvant and neoadjuvant therapy with tyrosine kinase inhibitors have shown to both improve survival and resectability, respectively.
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