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Article ; Online: PROF. PHD. HENRIQUE WALTER PINOTTI: 1929 - 2010. FOUNDER OF THE BRAZILIAN COLLEGE OF DIGESTIVE SURGERY.

Cecconello, Ivan / Santo, Marco Aurélio

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

2022 Volume 35, Page(s) e1669

MeSH term(s)	Brazil ; Digestive System Surgical Procedures ; History, 20th Century ; Humans
Language	English
Publishing date	2022-06-24
Publishing country	Brazil
Document type	Editorial ; Historical Article
ISSN	2317-6326
ISSN (online)	2317-6326
DOI	10.1590/0102-672020210002e1669
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Article ; Online: The complex assessment of anastomosis' perfusion following esophagectomy: Set in stone?

Takeda, Flavio Roberto / Cecconello, Ivan

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2020 Volume 47, Issue 6, Page(s) 1491–1492

MeSH term(s)	Anastomosis, Surgical ; Anastomotic Leak ; Esophagectomy ; Humans ; Perfusion
Language	English
Publishing date	2020-11-24
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2020.11.010
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS FISTULA FOLLOWING ESOPHAGECTOMY: A PROBLEM WITH NO SOLUTION?

Takeda, Flavio Roberto / Sallum, Rubens Aissar / Cecconello, Ivan / Nahas, Sérgio Carlos

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

2022 Volume 34, Issue 3, Page(s) e1619

MeSH term(s)	Anastomosis, Surgical/adverse effects ; Esophageal Neoplasms/surgery ; Esophagectomy/adverse effects ; Fistula ; Humans ; Treatment Outcome
Language	Portuguese
Publishing date	2022-01-05
Publishing country	Brazil
Document type	Letter
ISSN	2317-6326
ISSN (online)	2317-6326
DOI	10.1590/0102-672020210002e1619
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Article ; Online: A NEW APPROACH FOR HEMORRHOID DISEASE: SELECTIVE DEARTERIALIZATION AND MUCOPEXY WITHOUT DOPPLER GUIDANCE.

Sobrado, Carlos Walter / Sobrado, Lucas Faraco / Nahas, Sergio Carlos / Cecconello, Ivan

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

2021 Volume 34, Issue 1, Page(s) e1560

Abstract: Background: The surgical procedure: three dearterializations and three mucopexies.Transanal hemorrhoidal dearterialization (THD) is safe and effective minimally invasive treatment for hemorrhoidal disease, but reports regarding recurrence and ... ...

Abstract	Background: The surgical procedure: three dearterializations and three mucopexies.Transanal hemorrhoidal dearterialization (THD) is safe and effective minimally invasive treatment for hemorrhoidal disease, but reports regarding recurrence and postoperative complications (pain and tenesmus) vary significantly. Aim: To evaluate if selective dearterialization and mucopexy at the symptomatic hemorrhoid only, without Doppler guidance, achieves adequate control of the prolapse and bleeding and if postoperative morbidity is reduced with this technique. Methods: Twenty consecutive patients with grade II and III hemorrhoids were treated with this new approach and were evaluated for postoperative complications and recurrence. Results: Control of prolapse and bleeding was achieved in all patients (n=20). Postoperative complications were tenesmus (n=2), external hemorrhoidal thrombosis (n=2) and urinary retention (n=2). After a mean follow-up of 13 months no recurrences were diagnosed. Conclusion: Selective dearterialization and mucopexy is safe and achieves adequate control of prolapse and bleeding and, by minimizing sutures in the anal canal, postoperative morbidity is diminished. Doppler probe is unnecessary for this procedure, which makes it also more interesting from an economic perspective.
MeSH term(s)	Anal Canal ; Arteries/surgery ; Hemorrhoidectomy ; Hemorrhoids/surgery ; Humans ; Ligation ; Rectum ; Treatment Outcome ; Ultrasonography, Doppler
Language	Portuguese
Publishing date	2021-05-14
Publishing country	Brazil
Document type	Journal Article
ISSN	2317-6326
ISSN (online)	2317-6326
DOI	10.1590/0102-672020210001e1560
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Article ; Online: Laparoscopic transhiatal esophagectomy in esophageal cancer patients with high-risk post-operative complications.

Takeda, Flavio Roberto / Sallum, Rubens Antonio Aissar / Ribeiro, Ulysses / Cecconello, Ivan

Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

2021 Volume 35, Issue 1

Abstract: Surgical treatment of esophageal cancer is challenging, due to considerable morbidity, especially in high surgical risk patients. While transhiatal esophagectomy leads to good oncological outcomes and reduced postoperative complications, less invasive ... ...

Abstract	Surgical treatment of esophageal cancer is challenging, due to considerable morbidity, especially in high surgical risk patients. While transhiatal esophagectomy leads to good oncological outcomes and reduced postoperative complications, less invasive techniques might further improve outcomes. Our goal was to compare results of laparoscopic transhiatal esophagectomy (LTE) with open transhiatal esophagectomy (OTE) in esophageal cancer patients at high surgical risk. From 2014 to 2020, 128 patients were identified. Seventy received OTE while 51 received LTE. After propensity score matching (1:1), postoperative complications, analysis of overall and disease-free survival, and survival-related prognostic factors were assessed in two groups of 48 patients. Ninety-one (77%) patients were men with a mean age of 65 ± 10.3 years. Those who underwent OTE experienced more clinical and surgical complications. In LTE patients, the number of mean resected lymph nodes was 25.9, and in patients who had OTE, it was 17.4 (P < 0.001). Overall survival was 56.0% in the LTE group and 33.6% (P = 0.023) in the OTE group. In multivariable analysis of overall survival, open surgery and incomplete pathological response were seen as worse negative factors. In multivariable analysis, metastatic lymph nodes, incomplete pathologic response, surgical complications, and a Charlson's index > 2 (P = 0.014) were associated with poor prognosis. Both surgical methods are safe with similar morbidity and mortality; however, LTE was associated with fewer complications, a higher number of resected lymph nodes, better overall survival, and more prognostic factors related to global and disease-free overall survival in high-risk patients.
MeSH term(s)	Aged ; Esophageal Neoplasms/surgery ; Esophagectomy/adverse effects ; Humans ; Laparoscopy ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-03-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	639470-x
ISSN	1442-2050 ; 1120-8694
ISSN (online)	1442-2050
ISSN	1120-8694
DOI	10.1093/dote/doab022
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Zs.A 2378: Show issues

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Article ; Online: Robotic-assisted compared with laparoscopic incisional hernia repair following oncologic surgery: short- and long-term outcomes of a randomized controlled trial.

Costa, Thiago Nogueira / Abdalla, Ricardo Zugaib / Tustumi, Francisco / Junior, Ulysses Ribeiro / Cecconello, Ivan

Journal of robotic surgery

2022 Volume 17, Issue 1, Page(s) 99–107

Abstract: Background: Patients with abdominal site cancer are at risk for incisional hernia after open surgery. This study aimed to compare the short- and long-term outcomes of robotic-assisted (RVIHR) with the laparoscopic incisional hernia repair (LVIHR) in an ... ...

Abstract	Background: Patients with abdominal site cancer are at risk for incisional hernia after open surgery. This study aimed to compare the short- and long-term outcomes of robotic-assisted (RVIHR) with the laparoscopic incisional hernia repair (LVIHR) in an oncologic institute. Methods: This is a single-blinded randomized controlled pilot trial. Patients were randomized into two groups: RVIHR and LVIHR. Results: Groups have similar baseline characteristics (LVIHR: N = 19; RVIHR: N = 18). No difference was noted in the length of hospital stay (RVIHR: 3.67 ± 1.78 days; LVIHR: 3.95 ± 2.66 days) and postoperative complications (16.7 versus 10.5%; p = 0.94). The mean operating time for RVIHR was significantly longer than LVIHR (RVIHR was 355.6 versus 293.5 min for LVIHR; p = 0.04). Recurrence was seen in three patients in LVIHR and two in RVIHR at 24-month follow-up, with no significant difference. (p > 0.99). Conclusion: Laparoscopic and robotic-assisted incisional hernia repair show similar short- and long-term outcomes for cancer patients.
MeSH term(s)	Humans ; Incisional Hernia/surgery ; Incisional Hernia/etiology ; Robotic Surgical Procedures/methods ; Herniorrhaphy/adverse effects ; Neoplasm Recurrence, Local/etiology ; Hernia, Ventral/surgery ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Laparoscopy/adverse effects ; Surgical Mesh
Language	English
Publishing date	2022-03-30
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-022-01403-y
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Article ; Online: ROBOTIC ASSISTED VERSUS LAPAROSCOPIC DISTAL PANCREATECTOMY: A RETROSPECTIVE STUDY.

Jureidini, Ricardo / Namur, Guilherme Naccache / Ribeiro, Thiago Costa / Bacchella, Telesforo / Stolzemburg, Lucas / Jukemura, José / Ribeiro Junior, Ulysses / Cecconello, Ivan

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

2023 Volume 36, Page(s) e1783

Abstract: Background: Minimally invasive distal pancreatectomy (MIDP) is associated with less blood loss and faster functional recovery. However, the benefits of robotic assisted distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) are ... ...

Abstract	Background: Minimally invasive distal pancreatectomy (MIDP) is associated with less blood loss and faster functional recovery. However, the benefits of robotic assisted distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) are unknown. Aims: To compare RDP versus LDP for surgical treatment of benign lesions, pre-malignant and borderline malignant pancreatic neoplasias. Methods: This is a retrospective study comparing LDP with RDP. Main outcomes were overall morbidity and overall costs. Secondary outcomes were pancreatic fistula (PF), infectious complications, readmission, operative time (OT) and length of hospital stay (LOS). Results: Thirty patients submitted to LDP and 29 submitted to RDP were included in the study. There was no difference regarding preoperative characteristics. There was no difference regarding overall complications (RDP - 72,4% versus LDP - 80%, p=0,49). Costs were superior for patients submitted to RDP (RDP=US$ 6,688 versus LDP=US$ 6,149, p=0,02), mostly due to higher costs of surgical materials (RDP=US$ 2,364 versus LDP=1,421, p=0,00005). Twenty-one patients submitted to RDP and 24 to LDP developed pancreatic fistula (PF), but only 4 RDP and 7 LDP experienced infectious complications associated with PF. OT (RDP=224 min. versus LDP=213 min., p=0.36) was similar, as well as conversion to open procedure (1 RDP and 2 LDP). Conclusions: The postoperative morbidity of robotic distal pancreatectomy is comparable to laparoscopic distal pancreatectomy. However, the costs of robotic distal pancreatectomy are slightly higher.
MeSH term(s)	Humans ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Pancreatic Fistula/etiology ; Pancreatic Fistula/surgery ; Pancreatectomy/methods ; Laparoscopy/methods ; Treatment Outcome ; Pancreatic Neoplasms/surgery ; Length of Stay ; Postoperative Complications/epidemiology
Language	English
Publishing date	2023-12-08
Publishing country	Brazil
Document type	Journal Article
ISSN	2317-6326
ISSN (online)	2317-6326
DOI	10.1590/0102-672020230065e1783
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Article ; Online: CHARACTERIZATION OF THE PSYCHOLOGICAL TYPOLOGY IN ESOPHAGEAL CANCER PATIENTS.

Pinto, Stela Duarte / Rodriguez, Lórgio Henrique Diaz / Takeda, Flávio Roberto / Tacconi, Marcos Roberto / Sallum, Rubens Antonio Aissar / Cecconello, Ivan / Ribeiro Junior, Ulysses

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

2023 Volume 35, Page(s) e1715

Abstract: Background: Esophageal cancer is an environment-related disease, and the most important risk factors are alcohol intake and smoking, in addition to gastroesophageal reflux in obese patients. The characterization of the patients' personality can ... ...

Abstract	Background: Esophageal cancer is an environment-related disease, and the most important risk factors are alcohol intake and smoking, in addition to gastroesophageal reflux in obese patients. The characterization of the patients' personality can contribute to the perception of how everyone adapts to the social environment and what relationship one can establish with themselves and with others. Aim: The aim of this study was to identify the psychological typology in patients with esophageal cancer. Methods: The psychological typology of patients was defined using the Typological Assessment Questionnaire. In addition, the aspects of psychological assessment were studied to access the particularities of each patient, especially their reaction to the diagnosis and the meaning attributed to the disease. Results: A total of 90 patients with esophageal cancer, aged over 18 years, who completed high school, and were interviewed at the first medical appointment, were included. The introverted attitude was predominant (83.33%). The most common psychological type was introverted sensation, with feeling as a secondary function (43.3%), and the second most frequent was introverted feeling, with sensation as a secondary function (24.4%). From this psychological assessment, a variety of defensive mechanisms were found to minimize distress. Most patients made use of adaptive defenses in the face of the illness process. Conclusion: The identification of the psychological typology allows the most effective assistance in directing the peculiar needs of each patient. In addition, it contributes to the care team to individualize treatments based on specific psychological characteristics.
MeSH term(s)	Adult ; Humans ; Esophageal Neoplasms/psychology
Language	English
Publishing date	2023-01-09
Publishing country	Brazil
Document type	Journal Article
ISSN	2317-6326
ISSN (online)	2317-6326
DOI	10.1590/0102-672020220002e1715
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Article ; Online: ROBOTIC-ASSISTED VERSUS LAPAROSCOPIC INCISIONAL HERNIA REPAIR: DIFFERENCES IN DIRECT COSTS FROM A BRAZILIAN PUBLIC INSTITUTE PERSPECTIVE.

Costa, Thiago Nogueira / Tustumi, Francisco / Ferros, Lucas Sousa Maia / Colonno, Bárbara Buccelli / Abdalla, Ricardo Zugaib / Ribeiro-Junior, Ulysses / Cecconello, Ivan

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

2023 Volume 35, Page(s) e1714

Abstract: Background: Robotic-assisted surgery research has grown dramatically in the past two decades and the advantages over traditional videolaparoscopy have been extensively debated. For hernias, the robotic system can increase intraoperative strategies, ... ...

Abstract	Background: Robotic-assisted surgery research has grown dramatically in the past two decades and the advantages over traditional videolaparoscopy have been extensively debated. For hernias, the robotic system can increase intraoperative strategies, especially in complex hernias or incisional hernias. Aims: This study aimed to compare the direct cost differences between robotic and laparoscopic hernia repair and determine each source of expenditure that may be related to the increased costs in a robotic program from the perspective of a Brazilian public institution. Methods: This study investigated the differences in direct costs from the data generated from a trial protocol (ReBEC: RBR-5s6mnrf). Patients with incisional hernia were randomly assigned to receive laparoscopic ventral incisional hernia repair (LVIHR) or robotic ventral incisional hernia repair (RVIHR). The direct medical costs of hernia treatment were described in the Brazilian currency (R$). Results: A total of 19 patients submitted to LVIHR were compared with 18 submitted to RVIHR. The amount spent on operation room time (RVIHR: 2,447.91±644.79; LVIHR: 1,989.67±763.00; p=0.030), inhaled medical gases in operating room (RVIHR: 270.57±211.51; LVIHR: 84.55±252.34; p=0.023), human resources in operating room (RVIHR: 3,164.43±894.97; LVIHR: 2,120.16±663.78; p<0.001), material resources (RVIHR: 3,204.32±351.55; LVIHR: 736.51±972.32; p<0.001), and medications (RVIHR: 823.40±175.47; LVIHR: 288.50±352.55; p<0.001) for RVIHR was higher than that for LVIHR, implying a higher total cost to RVIHR (RVIHR: 14,712.24±3,520.82; LVIHR: 10,295.95±3,453.59; p<0.001). No significant difference was noted in costs related to the hospital stay, human resources in intensive care unit and ward, diagnostic tests, and meshes. Conclusion: Robotic system adds a significant overall cost to traditional laparoscopic hernia repair. The cost of the medical and robotic devices and longer operative times are the main factors driving the difference in costs.
MeSH term(s)	Humans ; Incisional Hernia/surgery ; Robotic Surgical Procedures/methods ; Brazil ; Hernia, Ventral/surgery ; Laparoscopy/methods ; Herniorrhaphy/methods ; Surgical Mesh
Language	English
Publishing date	2023-01-09
Publishing country	Brazil
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2317-6326
ISSN (online)	2317-6326
DOI	10.1590/0102-672020220002e1714
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Article ; Online: The relationship of major depressive disorder with Crohn's disease activity.

Facanali, Carolina Bortolozzo Graciolli / Sobrado Junior, Carlos Walter / Fraguas Junior, Renério / Facanali Junior, Marcio Roberto / Boarini, Lucas Rodrigues / Sobrado, Lucas Faraco / Cecconello, Ivan

Clinics (Sao Paulo, Brazil)

2023 Volume 78, Page(s) 100188

Abstract: Introduction: Crohn's disease (CD) has been related to an increased prevalence of psychiatric disorders and suicide risk (SR). However, the nature of their relationship still deserves clarification. The aim of this study is to assess the prevalence of ... ...

Abstract	Introduction: Crohn's disease (CD) has been related to an increased prevalence of psychiatric disorders and suicide risk (SR). However, the nature of their relationship still deserves clarification. The aim of this study is to assess the prevalence of major depressive disorder (MDD) in patients with CD, and to investigate the relationship between MDD and CD outcomes. Methods: A cross-sectional study involving CD patients was performed. CD activity was evaluated by the Harvey-Bradshaw index and CD phenotype by the Montreal classification. The presence of MDD was assessed by the Patient Health Questionnaire score-9 (PHQ-9). Sociodemographic data and other characteristics were retrieved from electronic medical records. Results: 283 patients with CD were included. The prevalence of MDD was 41.7%. Females had a risk of MDD 5.3 times greater than males. CD disease duration was inversely correlated with MDD severity. Individuals with active CD were more likely to have MDD (OR = 796.0; 95% CI 133.7‒4738.8) than individuals with CD remission. MDD was more prevalent in inflammatory behavior (45.5%) and there were no statistical differences regarding the disease location. 19.8% of the sample scored positive for SR. Conclusion: The present results support data showing an increased prevalence of MDD in individuals with CD. Additionally, it indicates that MDD in CD might be related to the activity of CD. Prospective studies are warranted to confirm these results and to address whether MDD leads to CD activity, CD activity leads to MDD or both ways are existent.
MeSH term(s)	Male ; Female ; Humans ; Crohn Disease/complications ; Crohn Disease/epidemiology ; Depressive Disorder, Major/epidemiology ; Cross-Sectional Studies ; Prospective Studies
Language	English
Publishing date	2023-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182801-5
ISSN	1980-5322 ; 1807-5932
ISSN (online)	1980-5322
ISSN	1807-5932
DOI	10.1016/j.clinsp.2023.100188
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