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Adenoma hepático gigante associado com uso abusivo de esteróide androgênico anabolizante: relato de caso Giant hepatic adenoma associated with anabolic-androgenic steroid abuse: case report
Sergio Renato Pais-Costa,Olímpia Alves Teixeira Lima,Aloisio Fernandes Soares
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2012,
Abstract:
Laparoscopic left lateral segmentectomy for metachronic metastases of small intestine adenocarcinoma: a case report
Pais-Costa, Sergio Renato;Araujo, Sergio Luiz Melo;Lima, Olímpia Alves Teixeira;Paes, Marcio Almeida;Martins, Sandro José;
Journal of Coloproctology (Rio de Janeiro) , 2011, DOI: 10.1590/S2237-93632011000400012
Abstract: hepatectomy has been the standard treatment for metachronic metastases of non-colorectal (ncr) origin, mainly when the disease-free interval is more than two years. laparoscopic hepatectomy has become the golden standard mainly for left side resections, due to lower morbidity, shorter hospital stay, early recovery and good cosmetic outcome. the authors report the case of a female patient with two metachronic metastases (ten years of disease-free survival), of non-colorectal origin (adenocarcinoma of small intestine), treated by laparoscopic left lateral segmentectomy (left hepatic lobectomy) with success. the postoperative progress was satisfactory. to date, the patient has presented no tumoral recurrence (six months of follow-up period). laparoscopic left lateral segmentectomy can be satisfactorily performed in selected cases of hepatic metastasis. this approach presents low morbidity and good cosmetic result. the lack of alternative treatments and the poor prognosis of untreated cases have justified surgical resection in order to increase overall survival. nevertheless, this approach should be performed by hepatic surgery expertise teams trained on advanced laparoscopic procedures.
Cistoadenocarcinoma biliar extra-hepático mimetizando tumor de Klatskin Extrahepatic biliary cystadenocarcinoma mimicking Klatskin tumor
Sergio Renato Pais-Costa,Sandro Jose Martins,Sergio Luiz Melo Araujo,Olímpia Alves Teixeira Lima
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2013,
Abstract:
Successful surgical management of an extrahepatic biliary cystadenocarcinoma
Sergio Renato Pais-Costa,Sandro J. Martins,Sergio L.M. Araújo,Olímpia A. T. Lima
Rare Tumors , 2011, DOI: 10.4081/rt.2011.e36
Abstract: Extrahepatic bile duct cancer is an uncommon disease, and few cases are curable by surgery. We report a case of extrahepatic biliary cystadenocarcinoma (BCAC) associated with atrophy of the left hepatic lobe. A 54-year old male was admitted with painless obstructive jaundice and a hepatic palpable mass noticed one month before presentation. Liver functions tests were consistent with cholestatic damage and serum carbohydrate antigen 19.9 (CA 19-9) was increased before treatment. Magnetic resonance imaging (MRI) disclosed dilatation of the left hepatic bile duct with irregular wall thickening close to the hepatic confluence, and atrophy of left hepatic lobe. The patient was submitted to en bloc extended left hepatectomy with resection of caudate lobe, hilar lymphadenectomy, and suprapancreatic biliary tree resection. All surgical margins were grossly negative, and postoperative course was uneventful, except for a minor bile leak. The patient was discharged on the 15th postoperative day; he is alive without tumor recurrence one year after primary therapy. Although technically challenging, extended en bloc resection is feasible in adults with extrahepatic BCAC and can improve survival with acceptable and manageable morbidity.
Laparoscopic hepatectomy: indications and results from 18 resectable cases
Sergio Renato Pais-Costa,Sergio Luiz Melo Araujo,Olímpia Alves Teixeira Lima,Alexandre Chartuni Pereira Teixeira
Einstein (S?o Paulo) , 2011,
Abstract: Objective: To evaluate the early and late results from laparoscopichepatectomy procedures at a tertiary hospital in Brasília (DF), Brazil. Methods: The authors report on a series of 18 patients (11 women) who underwent laparoscopic hepatectomy performed by a single surgical team at Santa Lúcia Hospital, in Brasília, between June 2007 and December 2010. Age ranged from 21 to 71 years (median = 43 years).There were eleven women and seven men. Nine patients had benigndiseases and nine had malignant lesions. The lesion diameter rangedfrom 1.8 to 12 cm (mean: 4.96 cm). Results: Six major hepatectomyprocedures and 12 minor hepatectomy procedures were performed.The mean duration of the operation was 205 minutes (range: 90 to 360minutes). The mean intraoperative blood loss was 300 mL (range: 100to 1,500 mL). Two patients received a transfusion (11%). There wasone conversion to open surgery. There was no death and no patientunderwent reoperation. The postoperative morbidity rate was 11% (n =2). One patient presented with a minor complication (lobar pneumonia)while other presented with two major complications (intraoperativebleeding and incisional hernia). The median length of hospital staywas 4 days (range: 2 to 11 days). The median time to return to normalactivities was 13 days (range: 7 to 40 days). Conclusion: Laparoscopichepatectomy is a safe surgical approach for treating both benign andmalignant hepatic lesions. This small series showed no mortality, lowmorbidity and good cosmetic results.
Adenocarcinoma da vesícula biliar: avalia??o dos fatores prognósticos em 100 casos ressecados no Brasil
Pais-Costa, Sergio Renato;Farah, José Francisco de Matos;Artigiani-Neto, Ricardo;Franco, Maria Isete Fares;Martins, Sandro José;Goldenberg, Alberto;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2012, DOI: 10.1590/S0102-67202012000100004
Abstract: background: in spite its relative rarity, gallbladder adenocarcinoma is a neoplasm who presents an aggressive biologic behavior. the single curative treatment has been radical surgical resection with free margin. prognostic factors has been studied because are very important to identify long-term survival patients which may benefit of aggressive surgical resection. aim: to evaluate long-term prognostic predictors from gallbladder cancer. methods: the medical records of all patients that presented confirmed histological diagnosis of gallbladder adenocarcinoma operated over a 14 year period were identified and retrospectively reviewed. uni and multivariate analysis was done. results: total sample was 100 patients. median age was 71 years (34 to 93). there were 17 men and 83 women. lesion distribution according to tnm stage system was: i (n=22), ii (n=59), iii (n=6), iv (n=4) and unknown (n=9). fifty two patients underwent radical resection (r0) while 48 to palliative surgery (r1-r2). overall major morbidity was 14%, while postoperative surgical mortality rate (30th postoperative day) was 12 %. five-year survival rate was 28% while median of survival was 10 months. multivariate analysis identified six prognostic factors: t stage, serum level of ca 19.9, gallbladder perforation, lymphatic embolization, surgical historical cohort (after 2002) and hilar lymphadenectomy. conclusion: prognostic factors were: t stage, serum level of ca 19.9, gallbladder perforation, lymphatic embolization, surgical historical cohort and hilar lymphadenectomy.
Contribui??o para o estudo da vers?o portuguesa da Positive and Negative Affect Schedule (PANAS): I - Abordagem teórica ao conceito de afecto
Galinha,Iolanda Costa; Pais-Ribeiro,Luis;
Análise Psicológica , 2005,
Abstract: the study of affect and its correlates has been given great importance by the various domains of psychology. the study of affect has been shared by several fields of psychology and through multiple perspectives. these are some of the reasons why the concept of affect has became a multifaceted construct, subject of multiple definitions and sometimes difficult to integrate. the article aims to clarify the concept of affect based on the literature revision of the works that developed an integration of the several facets of the concept. this integration was made through the identification and articulation of the several levels of analyse of the construct: the state affect (emotions); the humor (depression and anxiety); and trait affect (personality). the article presents the several models of affect and the discussions: bi-dimensionality versus multidimensionality of the concept of affect; and orthogonality (independence) versus bipolarity (inverse correlation), between positive and negative affect. the discussion about the structure and dimensionality of affect is still open, however, several recent studies pointed out some of the possible causes for the divergence in the scientific results.
Os benefícios da ressec??o anterior baixa em monobloco para o cancer de ovário avan?ado: dez anos de experiência em um único centro terciário
Costa, Sergio Renato Pais;Lupinacci, Renato Arioni;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000200003
Abstract: introduction: the cornerstone of ovarian cancer treatment has been the association of debulking surgery with platinum based chemotherapy. when this neoplasm invades adjacent pelvic organs, in order to attain an optimal debulking should be performed an en bloc multivisceral pelvic resection. aim: the objectives of this study were to assess the safety, efficacy and impact on survival of low anterior en bloc resection for primary advanced epithelial ovarian cancer. methods: complete follow-up data were available on 19 patients who underwent this surgical procedure for advanced ovarian cancer between january 1996 and june 2006. these subjects presented a median age of 58 years (24-77). all patients underwent optimal cytoreduction (less than 1cm of residual disease). results: the postoperative mortality was 5 % (n=1) while overall major morbidity was 26,3 % (n=5).the overall three-year survival rate was 77 % while median of survival time was 42 months. conclusions: low anterior en bloc resection, when it is necessary must not be obstacle to obtain an optimal surgery. in despite its high morbidity presents acceptable mortality. long-term disease control may be attained with this approach.
Resultados do tratamento do cancer colorretal (T4) perfurado: análise de 14 pacientes operados
Costa, Sergio Renato Pais;Lupinacci, Renato Arioni;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000300001
Abstract: aim: to report on a series of 14 patients with a complicated t4 colorectal cancer (perforated) and describe the outcomes (morbidity, mortality and long-term survival) following curative surgery. methods: complete follow-up data were available on 14 patients who underwent curative surgery from perforated colorectal adenocarcinoma between 1999 and 2007. both epidemiological and surgical findings were analyzed. long-term survival was evaluated too. results: the postoperative mortality was 14 % (n=2). the overall morbidity was 50 % (n=7). ten resections were r0 (71 %).lymph node involvement was present in six patients (43%), and all of them died due to tumor recurrence (4-19 months). six patients (50%) were alive without tumor recurrence (between 18 and 70 months/follow-up). the overall 5-year survival rate was 25% (n=3). conclusion: radical resection (r0) of pefurated colorectal cancer presents high rates of morbidity and mortality. in spite of its high rate of tumor recurrence, this procedure may offer long-term disease control.
Giant dermatofibrosarcoma protuberans on the abdominal wall
Sergio Renato Pais Costa,Alexandre Cruz Henriques
Einstein (S?o Paulo) , 2007,
Abstract: Dermatofibrosarcoma protuberans is probably best considered as alow-grade dermal sarcoma. It is an uncommon type of sarcoma thatmay occur anywhere in the body. It rarely arises on the abdominal wall.It often affects young patients and appears as a nodular mass. Thegrowth pattern is usually slow and persistent. These lesions enlargeover many years, becoming protuberant. These tumors have a locallyaggressive nature and may recur frequently. They rarely metastasize.A wide resection with 2-3 cm free margins is the best treatment. Thispaper reports a rare type of abdominal wall sarcoma. A brief literaturereview is presented showing the surgical principles for treatingabdominal wall tumors and their outcome. Radical surgery and goodlocoregional control are shown to be significantly related.
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