Heitor Sado - Academia.edu (original) (raw)
Papers by Heitor Sado
Journal of Nuclear Medicine, 2015
We aimed to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentin... more We aimed to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentinel node (SN) detection in malignancies with different lymphatic drainage such as breast cancer, melanoma, and pelvic tumors. Methods: From 2010 to 2013, 1,508 patients were recruited in a multicenter study: 1,182 breast cancer, 262 melanoma, and 64 pelvic malignancies (prostate, cervix, penis, vulva). PI was followed by SPECT/CT 1-3 h after injection of 99m Tccolloid particles. Surgery was performed the same or next day. Results: Significantly more SNs were detected by SPECT/CT for breast cancer (2,165 vs. 1,892), melanoma (602 vs. 532), and pelvic cancer (195 vs. 138), all P , 0.001. The drainage basin mismatch between PI and SPECT/CT was 16.5% for breast cancer, 11.1% for melanoma, and 51.6% for pelvic cancers. Surgical adjustment was 17% for breast cancer, 37% for melanoma, and 65.6% for pelvic cancer. Conclusion: SPECT/CT detected more SNs and changed the drainage territory, leading to surgical adjustments in a considerable number of patients in all malignancies studied but especially in the pelvic cancer group because of this group's deep lymphatic drainage. We recommend SPECT/CT in all breast cancer patients with no SN visualized on PI, all patients with melanoma of the head and neck or trunk, all patients with pelvic malignancies, and those breast cancer and melanoma patients with unexpected drainage on PI.
Radiologia Brasileira, 2015
Radiologia Brasileira, 2008
Linfonodo sentinela após mamoplastia de aumento pela via transaxilar Radiol Bras. 2008 Set/Out;41... more Linfonodo sentinela após mamoplastia de aumento pela via transaxilar Radiol Bras. 2008 Set/Out;41(5):283-288 Artigo Original • Original Article
Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia, 2006
Wound healing is a complex process that deals with different biological and immunological systems... more Wound healing is a complex process that deals with different biological and immunological systems and is essential to keep the organism integrity. Three well-defined phases occur: inflammatory, proliferative and maturation. A failure or lengthy phase may result in a delay or absence of it. The aim of this paper is to analyse comparatively the histological alteration provided by the use of the aqueous extract of Orbignya phalerata, in the healing process of bladder surgical wounds. Forty adult, male Wistar rats were used. The experimental procedure consisted of a longitudinal 2 cm long bladder incision and single layer interrupted suture of 5-0 polyglactine 910. Post-operatively, the rats were randomly divided into two groups of 20. The substance was not used in the control group. The Orbignya phalerata aqueous solution was used in the study group. The animals were observed and killed three and seven days later. Comparative histological analysis was accomplished between the groups. S...
The Journal of Clinical Endocrinology & Metabolism, 2014
ABSTRACT Abstract Not Available.
Arquivos Brasileiros de Endocrinologia & Metabologia, 2011
Radiologia …, 2008
O câncer de mama representa a neoplasia de maior importância entre as mulheres. Estimativas norte... more O câncer de mama representa a neoplasia de maior importância entre as mulheres. Estimativas norte-americanas demonstram que, para cada oito mulheres, uma apresentará a doença no decorrer da vida (1) . Devido à crescente tendência de tratamento conservador do câncer ...
Aesthetic Plastic Surgery, 2007
In recent years, some surgeons have been warned of possible problems with sentinel lymph node dia... more In recent years, some surgeons have been warned of possible problems with sentinel lymph node diagnosis (SLND) for patients who have undergone transaxillary breast augmentation (TBA), although no scientific studies support this warning. The authors report two additional cases of breast cancer in which the SLND was successfully performed for patients with previous TBA. The surgical anatomy of the axilla, the groups of lymph nodes, and a personal way of performing TBA are described. Five other reports concerning the same issue are thoroughly discussed. Four of these are clinical in vivo reports, and one is a cadaver study. The four in vivo studies and what we are reporting now clearly demonstrate that what was said regarding possible problems in the SLND after TBA was not founded on clinical research and contradicts these five clinical findings.
Aesthetic Plastic Surgery, 2008
Background The transaxillary breast augmentation (TBA) technique has gained popularity because of... more Background The transaxillary breast augmentation (TBA) technique has gained popularity because of several advantages. However, the impact of the procedure on breast lymphatic drainage and sentinel node (SN) detection remains controversial. The objective of this study was to evaluate the lymphatic patterns and SN detection rates after TBA by using lymphoscintigraphy (LSG). Methods Twenty patients (40 breasts) who underwent TBA were evaluated by LSG immediately after periareolar injections of phytate-99 mTc at three time points: before TBA (Pre-LSG) and approximately 30 days (Recent-Post-LSG) and 6 months after TBA (Late-Post-LSG). Statistical analysis considered p \ 0.05 significant, or p \ 0.017 when Bonferroni correction was applied. Results All breasts drained primarily to the axillary SN. The binomial test did not show statistical differences in lymphatic drainage patterns between Pre-LSG and Recent-Post-LSG (p = 1), Pre-LSG and Late-Post-LSG (p = 0.625), and Recent-Post-LSG and Late-Post-LSG (p = 0.625). The average number of hot SN was 1.28 in Pre-LSG, 1.10 in Recent-Post-LSG, and 1.23 in Late-Post-LSG, without significant differences (p = 0.202). The average time of the first SN appearance was not significantly different (p = 0.186). Analysis of SN uptake percentage showed a significant difference between Pre-LSG and Recent-Post-LSG (p = 0.009), with a reduction of drainage magnitude in Recent-Post-LSG. Conclusion The preservation of axillary lymphatic drainage after TBA allowed for SN detection in all studied breasts. It seems that the applied surgical technique played an important role in axillary lymphatic integrity.
Acta Cirurgica Brasileira, 2006
Journal of Nuclear Medicine, 2015
We aimed to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentin... more We aimed to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentinel node (SN) detection in malignancies with different lymphatic drainage such as breast cancer, melanoma, and pelvic tumors. Methods: From 2010 to 2013, 1,508 patients were recruited in a multicenter study: 1,182 breast cancer, 262 melanoma, and 64 pelvic malignancies (prostate, cervix, penis, vulva). PI was followed by SPECT/CT 1-3 h after injection of 99m Tccolloid particles. Surgery was performed the same or next day. Results: Significantly more SNs were detected by SPECT/CT for breast cancer (2,165 vs. 1,892), melanoma (602 vs. 532), and pelvic cancer (195 vs. 138), all P , 0.001. The drainage basin mismatch between PI and SPECT/CT was 16.5% for breast cancer, 11.1% for melanoma, and 51.6% for pelvic cancers. Surgical adjustment was 17% for breast cancer, 37% for melanoma, and 65.6% for pelvic cancer. Conclusion: SPECT/CT detected more SNs and changed the drainage territory, leading to surgical adjustments in a considerable number of patients in all malignancies studied but especially in the pelvic cancer group because of this group's deep lymphatic drainage. We recommend SPECT/CT in all breast cancer patients with no SN visualized on PI, all patients with melanoma of the head and neck or trunk, all patients with pelvic malignancies, and those breast cancer and melanoma patients with unexpected drainage on PI.
Radiologia Brasileira, 2015
Radiologia Brasileira, 2008
Linfonodo sentinela após mamoplastia de aumento pela via transaxilar Radiol Bras. 2008 Set/Out;41... more Linfonodo sentinela após mamoplastia de aumento pela via transaxilar Radiol Bras. 2008 Set/Out;41(5):283-288 Artigo Original • Original Article
Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia, 2006
Wound healing is a complex process that deals with different biological and immunological systems... more Wound healing is a complex process that deals with different biological and immunological systems and is essential to keep the organism integrity. Three well-defined phases occur: inflammatory, proliferative and maturation. A failure or lengthy phase may result in a delay or absence of it. The aim of this paper is to analyse comparatively the histological alteration provided by the use of the aqueous extract of Orbignya phalerata, in the healing process of bladder surgical wounds. Forty adult, male Wistar rats were used. The experimental procedure consisted of a longitudinal 2 cm long bladder incision and single layer interrupted suture of 5-0 polyglactine 910. Post-operatively, the rats were randomly divided into two groups of 20. The substance was not used in the control group. The Orbignya phalerata aqueous solution was used in the study group. The animals were observed and killed three and seven days later. Comparative histological analysis was accomplished between the groups. S...
The Journal of Clinical Endocrinology & Metabolism, 2014
ABSTRACT Abstract Not Available.
Arquivos Brasileiros de Endocrinologia & Metabologia, 2011
Radiologia …, 2008
O câncer de mama representa a neoplasia de maior importância entre as mulheres. Estimativas norte... more O câncer de mama representa a neoplasia de maior importância entre as mulheres. Estimativas norte-americanas demonstram que, para cada oito mulheres, uma apresentará a doença no decorrer da vida (1) . Devido à crescente tendência de tratamento conservador do câncer ...
Aesthetic Plastic Surgery, 2007
In recent years, some surgeons have been warned of possible problems with sentinel lymph node dia... more In recent years, some surgeons have been warned of possible problems with sentinel lymph node diagnosis (SLND) for patients who have undergone transaxillary breast augmentation (TBA), although no scientific studies support this warning. The authors report two additional cases of breast cancer in which the SLND was successfully performed for patients with previous TBA. The surgical anatomy of the axilla, the groups of lymph nodes, and a personal way of performing TBA are described. Five other reports concerning the same issue are thoroughly discussed. Four of these are clinical in vivo reports, and one is a cadaver study. The four in vivo studies and what we are reporting now clearly demonstrate that what was said regarding possible problems in the SLND after TBA was not founded on clinical research and contradicts these five clinical findings.
Aesthetic Plastic Surgery, 2008
Background The transaxillary breast augmentation (TBA) technique has gained popularity because of... more Background The transaxillary breast augmentation (TBA) technique has gained popularity because of several advantages. However, the impact of the procedure on breast lymphatic drainage and sentinel node (SN) detection remains controversial. The objective of this study was to evaluate the lymphatic patterns and SN detection rates after TBA by using lymphoscintigraphy (LSG). Methods Twenty patients (40 breasts) who underwent TBA were evaluated by LSG immediately after periareolar injections of phytate-99 mTc at three time points: before TBA (Pre-LSG) and approximately 30 days (Recent-Post-LSG) and 6 months after TBA (Late-Post-LSG). Statistical analysis considered p \ 0.05 significant, or p \ 0.017 when Bonferroni correction was applied. Results All breasts drained primarily to the axillary SN. The binomial test did not show statistical differences in lymphatic drainage patterns between Pre-LSG and Recent-Post-LSG (p = 1), Pre-LSG and Late-Post-LSG (p = 0.625), and Recent-Post-LSG and Late-Post-LSG (p = 0.625). The average number of hot SN was 1.28 in Pre-LSG, 1.10 in Recent-Post-LSG, and 1.23 in Late-Post-LSG, without significant differences (p = 0.202). The average time of the first SN appearance was not significantly different (p = 0.186). Analysis of SN uptake percentage showed a significant difference between Pre-LSG and Recent-Post-LSG (p = 0.009), with a reduction of drainage magnitude in Recent-Post-LSG. Conclusion The preservation of axillary lymphatic drainage after TBA allowed for SN detection in all studied breasts. It seems that the applied surgical technique played an important role in axillary lymphatic integrity.
Acta Cirurgica Brasileira, 2006