5 results on '"Renan Bezerra Lira"'
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2. Protecting the skin during thyroidectomy
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Renan Bezerra Lira, Genival Barbosa de Carvalho, José Guilherme Vartanian, and Luiz Paulo Kowalski
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Thyroidectomy ,Surgical procedures, operative ,Esthetics ,Protection ,Skin ,Surgery ,RD1-811 - Abstract
In this note we describe the standard technical maneuver used in our department to protect the skin during thyroidectomy in order to get the best aesthetic result. We use surgical gloves to protect the skin during these operations to reduce the negative impact of thermal trauma and mechanical retractors and energy delivery devices at the edges of the skin incised. This practice is effective, inexpensive, rapid, reproducible and showed no complication in our experience of over 2,500 thyroidectomies.
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3. Evolution in the profile of thyroid cancer cases treated in an oncology reference service: what changed in the last 20 years
- Author
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Renan Bezerra Lira, Genival Barbosa de Carvalho, João Gonçalves Filho, and Luiz Paulo Kowalski
- Subjects
Thyroid gland ,Thyroid neoplasms ,Adenocarcinoma ,Thyroidectomy ,Surgery ,RD1-811 - Abstract
Objective: To evaluate the characteristics of thyroid carcinoma cases treated at a reference hospital for cancer between 2008 and 2010.Methods: we studied 807 cases and analyzed the following clinicopathologic variables: symptoms, risk factors, diagnostic tests, staging, histological type, treatment performed and complications.Results: Females were more affected, with 660 cases (82%). The average age at diagnosis was 44.5 years. Prior exposure to ionizing radiation was reported by 22 (3%) patients, a family history of thyroid cancer by 89 (11%), and 289 (36%) individuals reported other types of cancer in the family. The fine needle aspiration biopsy was the main parameter for surgical indication and was suggestive of carcinoma in 463 patients (57%). Papillary carcinoma was the most common histological type, with 780 cases (96.6%). There were 728 (90%) total thyroidectomies, 43 (5.3%) reoperations or partial thyroidectomies followed by totalization, 23 (2.8%) extended thyroidectomies and only 13 (1.6%) partial thyroidectomies (lobectomy with isthmectomy). Neck dissection associated with thyroidectomy was done in 158 patients (19.5%). We observed a predominance of tumors classified as T1 in 602 (74.6%) patients. Transient hypocalcemia was the most frequent complication.Conclusion: The results show that the worldwide increase in the incidence of thyroid cancer has changed the profile of patients seen at a referral service. In addition, there were changes in the type of surgical treatment used, with increased use of total thyroidectomy in relation to partial and subtotal ones, and decreased use of elective neck dissections.
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4. Robotic-assisted modified retroauricular cervical approach: initial experience in Latin America
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THIAGO CELESTINO CHULAM, RENAN BEZERRA LIRA, and LUIZ PAULO KOWALSKI
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Robotic Surgical Procedures ,Minimally Invasive Surgical Procedures ,Neck Dissection. ,Surgery ,RD1-811 - Abstract
ABSTRACT Objective: to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. Methods: fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water. Results: the presence of IGB led to increased wall thickness of the gastric body by expanding the muscle layer. These changes were apparently transient, since 30 days after the balloon withdrawal there was a tendency to return of the wall thickness values observed before the balloon insertion. Conclusion: the use of intragastric balloon for the treatment of obesity determines transient increase in the wall thickness of the gastric body caused by expanded muscle layer.
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5. Evolution in the profile of thyroid cancer cases treated in an oncology reference service: what changed in the last 20 years
- Author
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Genival Barbosa de Carvalho, Renan Bezerra Lira, João Gonçalves Filho, and Luiz Paulo Kowalski
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,lcsh:Surgery ,Thyroid neoplasms ,Adenocarcinoma ,Cohort Studies ,Thyroid carcinoma ,Young Adult ,Glândula tireoide ,medicine ,Carcinoma ,Humans ,Câncer de tireoide ,Child ,Referral and Consultation ,Thyroid cancer ,Aged ,Retrospective Studies ,Aged, 80 and over ,Thyroid gland ,medicine.diagnostic_test ,business.industry ,Thyroid ,Thyroidectomy ,Cancer ,Neck dissection ,lcsh:RD1-811 ,Middle Aged ,medicine.disease ,Surgery ,Fine-needle aspiration ,medicine.anatomical_structure ,Tireoidectomia ,Female ,business - Abstract
Objective: To evaluate the characteristics of thyroid carcinoma cases treated at a reference hospital for cancer between 2008 and 2010.Methods: we studied 807 cases and analyzed the following clinicopathologic variables: symptoms, risk factors, diagnostic tests, staging, histological type, treatment performed and complications.Results: Females were more affected, with 660 cases (82%). The average age at diagnosis was 44.5 years. Prior exposure to ionizing radiation was reported by 22 (3%) patients, a family history of thyroid cancer by 89 (11%), and 289 (36%) individuals reported other types of cancer in the family. The fine needle aspiration biopsy was the main parameter for surgical indication and was suggestive of carcinoma in 463 patients (57%). Papillary carcinoma was the most common histological type, with 780 cases (96.6%). There were 728 (90%) total thyroidectomies, 43 (5.3%) reoperations or partial thyroidectomies followed by totalization, 23 (2.8%) extended thyroidectomies and only 13 (1.6%) partial thyroidectomies (lobectomy with isthmectomy). Neck dissection associated with thyroidectomy was done in 158 patients (19.5%). We observed a predominance of tumors classified as T1 in 602 (74.6%) patients. Transient hypocalcemia was the most frequent complication.Conclusion: The results show that the worldwide increase in the incidence of thyroid cancer has changed the profile of patients seen at a referral service. In addition, there were changes in the type of surgical treatment used, with increased use of total thyroidectomy in relation to partial and subtotal ones, and decreased use of elective neck dissections. Objetivo: avaliar características casos de carcinoma de tireoide atendidos em um hospital de referência em câncer entre 2008 e 2010.Métodos: foram analisadas variáveis clínico-patológicas de 807 casos tratados em três anos: sintomas, fatores de risco, exames de diagnóstico, estadiamento, tipo histológico, tratamento realizado e complicações.Resultados: o sexo feminino foi o mais acometido com 660 casos (82%). A média de idade ao diagnóstico foi 44,5 anos. A exposição prévia à radiação ionizante foi referida por 22 (3%) pacientes, a história familiar de câncer de tireoide por 89 (11%) pacientes e 289 (36%) pacientes relataram outros tipos de câncer na família. A punção aspirativa por agulha fina foi o principal parâmetro para indicação operatória e foi sugestiva de carcinoma em 463 pacientes (57%). O carcinoma papilífero foi o tipo histológico mais incidente, com 780 casos (96,6%). Foram realizadas 728 (90%) tireoidectomias totais, 43 (5,3%) reoperações ou tireoidectomias parciais seguidas de totalização, 23 (2,8%) tireoidectomias ampliadas e apenas 13 (1,6%) tireoidectomias parciais (lobectomia com istmectomia). O esvaziamento cervical, associado à tireoidectomia, foi feito em 158 pacientes (19,5%). Observamos predomínio dos tumores classificados como T1 em 602 (74,6%) dos pacientes. A hipocalcemia transitória foi a complicação mais frequente.Conclusão: os resultados mostram que o aumento mundial da incidência do câncer de tireoide alterou o perfil dos pacientes atendidos em serviço de referência. Além disso, ocorreram mudanças no tipo de tratamento cirúrgico empregado, com aumento no uso da tireoidectomia total em relação às parciais e subtotais e diminuição do uso de esvaziamento cervical eletivo para estas neoplasias.
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