ORCID Profile
0000-0001-7607-7168
Current Organisation
Universidade de São Paulo
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Publisher: Baishideng Publishing Group Inc.
Date: 2010
Publisher: Wiley
Date: 09-08-2022
DOI: 10.1111/TID.13920
Abstract: Carbapenem‐resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients’ survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model. Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF‐SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT. A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato‐renal syndrome, worst CLIF sofa score, and use of beta‐lactam/beta‐lactamase inhibitor increased the probability of a patient having pre‐LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%. We created a model able to predict CRE colonization at LT based on easy‐to‐obtain features that could guide antibiotic prophylaxis image
Publisher: Mary Ann Liebert Inc
Date: 2010
Abstract: Laparoscopic liver resections are becoming a common procedure, and bleeding remains the major concern during parenchymal transection. Total vascular inflow occlusion can be performed, but ischemic reperfusion injuries can lead to postoperative morbidity. On the other hand, hemihepatic inflow occlusion, leading to hemiliver ischemia, decreases the amount of liver parenchyma submitted to reperfusion damage and offers the advantage of reduced blood loss. The aim of this work was to describe our experience with laparoscopic the half-Pringle maneuver for segmentar or nonanatomic liver resctions. Eight patients submitted to laparoscopic liver resection in a single tertiary center. There were 5 women and 3 men with a mean age of 40.2 years (range, 26-54). Mean tumor size was 4.1 cm (range, 2.6-6.0), and mean hospital stay was 3.1 days (1-5). There were 3 liver adenomas, 2 hepatocellular carcinomas, 1 metastatic melanoma, 1 metastatic colorectal carcinoma, and 1 peripheral colangiocarcinoma. No postoperative complications or mortalities were observed. Results demonstrate that laparoscopic liver resection with the half-Pringle maneuver is feasible and safe and may be included in the technical armamentarium of laparoscopic liver resections for a selected group of patients.
Publisher: FapUNIFESP (SciELO)
Date: 10-2015
DOI: 10.1590/0100-69912015005009
Abstract: Objective: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. Methods : From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. Results : The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases. We performed 33 resections (1 to 4 nodules per patient). The procedures performed were non-anatomical resections (n = 26), segmentectomy (n = 1), 2/3 bisegmentectomy (n = 1), 6/7 bisegmentectomy (n = 1), left hepatectomy (n = 2) and right hepatectomy (n = 2). The procedures contemplated postero-superior segments in 66.7%, requiring multiple or larger resections. The average operating time was 226 minutes (80-420), and anesthesia time, 360 minutes (200-630). The average size of resected nodes was 3.2 cm (0.8 to 10) and the surgical margins were free in all the analyzed specimens. Eight percent of patients needed blood transfusion and no case was converted to open surgery. The length of stay was 6.5 days (3-16). Postoperative complications occurred in 20% of patients, with no perioperative mortality. Conclusion : The video-assisted liver resection is feasible and safe and should be part of the liver surgeon armamentarium for resection of primary and secondary liver lesions.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2008
DOI: 10.1016/J.IJSU.2007.10.004
Abstract: Solitary fibrous tumor of the liver is extremely rare, with only 38 cases reported in the literature. We present one case of a SFT originating from the caudate lobe of the liver, treated by surgical resection and review the previous reported cases.
Publisher: FapUNIFESP (SciELO)
Date: 12-2013
DOI: 10.1590/S0102-67202013000400011
Abstract: RACIONAL: Aproximadamente 50% dos pacientes com tumor colorretal apresentam metástase hepática sendo a hepatectomia o procedimento terapêutico de escolha. Discutem-se ersos fatores prognósticos entre eles, a margem cirúrgica é fator sempre recorrente, pois não existe consenso da distância mínima necessária entre o nódulo metastático e a linha de secção hepática. OBJETIVOS: Avaliar as margens cirúrgicas nas ressecções de metástases hepáticas de câncer colorretal e sua correlação com reci a local e sobrevida. MÉTODOS: Estudo retrospectivo, baseado na revisão dos prontuários de 91 pacientes submetidos à ressecção de metástases hepáticas de neoplasia colorretal. Foi realizada revisão histopatológica de todos os casos com aferição da menor margem cirúrgica e observar o resultado tardio em relação à reci a e sobrevida. RESULTADOS: Não houve diferença estatística nas taxas de reci a e no tempo de sobrevivência global entre os pacientes com margens livres ou acometidas (R0vsR1), assim como não houve diferença entre as margens subcentimétricas e as maiores de 1 cm. A sobrevida livre de doença dos pacientes com margens microscopicamente acometidas foi significativamente menor do que dos com margens livres. A análise uni e multivariada não identificou a margem cirúrgica (R1, exígua ou menor que 1 cm) como fator de risco para reci a. CONCLUSÕES: As ressecções de metástases hepáticas com margens livres de doença, independentemente das dimensões da margem, não influenciou na reci a tumoral (intra ou extra-hepática) ou na sobrevida dos pacientes.
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.AMJSURG.2013.05.015
Abstract: Surgical resection is the gold standard therapy for the treatment of colorectal liver metastases (CRM). The aim of this study was to investigate the impact of tumor growth patterns on disease recurrence. We enrolled 91 patients who underwent CRM resection. Pathological specimens were prospectively evaluated, with particular attention given to tumor growth patterns (infiltrative vs pushing). Tumor recurrence was observed in 65 patients (71.4%). According to multivariate analysis, 3 or more lesions (P = .05) and the infiltrative tumor margin type (P = .05) were unique independent risk factors for recurrence. Patients with infiltrative margins had a 5-year disease-free survival rate significantly inferior to patients with pushing margins (20.2% vs 40.5%, P = .05). CRM patients with pushing margins presented superior disease-free survival rates compared with patients with infiltrative margins. Thus, the adoption of the margin pattern can represent a tool for improved selection of patients for adjuvant treatment.
Publisher: Elsevier BV
Date: 06-2012
Publisher: FapUNIFESP (SciELO)
Date: 09-2013
DOI: 10.1590/S0102-86502013000900004
Abstract: To investigate superoxide dismutase (SOD) activity in the portal vein endothelium and malondialdehyde acid (MDA) production in liver tissue of rats submitted to 70% hepatectomy. Twelve rats were distributed in two groups (hepatectomy and sham). Animals were sacrificed on post operative day 1 and portal vein, liver tissue and blood s les were collected. Portal vein SOD production was measured using lucigenin- lified chemiluminescence assays. MDA measurement was used as an index of oxidative stress through the formation of TBARS (Thiobarbituric Acid Reactive Species). There was no difference in post operative bilirubin, AST, ALT levels between groups. DHL level was higher in the hepatectomy group (p=0.01). MDA production in the remnant liver tissue and endothelial portal vein SOD activity were also significantly (p<0.05) elevated in the hepatectomy group when compared to control group. There was no correlation between MDA and SOD activity. SOD activity, on the other hand, showed a positive correlation with LDH level (p=0.038) and MDA levels showed a positive correlation with AST and ALT levels (p<0.001). There is an increased production of malondialdehyde acid in liver tissue after partial hepatectomy and increased activity of superoxide dismutase in portal vein endothelium as well.
No related grants have been discovered for Luiz Augusto Carneiro D'Albuquerque.