Laercio Gomes Lourenco - Academia.edu (original) (raw)

Papers by Laercio Gomes Lourenco

DESCRITORES-Neoplasias esofágicas. Esôfago. Radioterapia. Braquiterapia. RESUMO-Racional-O câncer... more DESCRITORES-Neoplasias esofágicas. Esôfago. Radioterapia. Braquiterapia. RESUMO-Racional-O câncer do esôfago ainda constitui neoplasia de difícil tratamento e de prognóstico muito ruim. Objetivo-Comparar a resposta do tratamento exclusivo com teleterapia isolada versus teleterapia associada à braquiterapia endoluminal de doentes portadores de carcinoma espinocelular avançado do esôfago. Método-Foram estudados 49 doentes portadores de carcinoma espinocelular avançado do esôfago médio em estádio clínico III (TNM). Os doentes foram divididos em dois grupos de doentes. O primeiro grupo foi submetido à teleterapia exclusiva com acelerador linear de partículas, dose média de 6000 cGy e o segundo à teleterapia na dose de 5040 cGy associada à braquiterapia endoluminal com Iridium 192 na dose de 1500 cGy. A braquiterapia foi iniciada uma a duas semanas após o término da teleterapia e dividida em três aplicações semanais de 500 cGy. Foram avaliadas as variáveis idade, sexo, raça, hábitos (tabagismo e etilismo), índice de massa corpórea (IMC), complicações com o tratamento, benefícios (melhora da dor e satisfação alimentar) e sobrevivência. Resultados-Os resultados quanto a qualidade de vida (satisfação alimentar, paliação da disfagia e dor) foram melhores no grupo submetido à teleterapia associada a braquiterapia. A sobrevivência foi maior no grupo de teleterapia associada a braquiterapia. Conclusão-Apesar do índice de cura do câncer espinocelular do esôfago ser quase nulo quando tratado com irradiação isolada, esta terapêutica constitui-se em uma forma de tratamento paliativo para grande parte dos doentes em que existe contra-indicação cirúrgica.

Arquivos Brasileiros de Cirurgia Digestiva Express, 2017

European Journal of Cancer, 2014

Background Primary gastric lymphomas are non-Hodgkin lymphomas that originate in the stomach and ... more Background Primary gastric lymphomas are non-Hodgkin lymphomas that originate in the stomach and are divided into low-grade and high-grade types. Low-grade lesions nearly always arise from mucosa-associated lymphoid tissue (MALT) secondary to chronic Helicobacter pylori infection and disseminate slowly. High-grade lesions may arise from a low grade-MALT component or arise de novo and can spread to lymph nodes, adjacent organs and tissues, or distant sites. Our aim was to analyse the cases of non-Hodgkin lymphomas with gastric involvement treated at a university hospital in southeastern Brazil and to assess the role of surgery in their treatment. Methods We did a survey of cases of gastric lymphoma treated at Hospital Sao Paulo-UNIFESP from 1996 to 2012. Findings A total of 626 cases were diagnosed with non-Hodgkin lymphoma, 30 cases with gastric involvement (5%). Among these, 19 cases were female and 11 were male, with a median age of 56.5 years. Fourteen cases were diagnosed as extranodal marginal zone lymphoma of MALT: 10 were H pylori (HP)-positive, one was HP-negative, and three had unknown HP status. Fourteen cases were diagnosed as diffuse large B-cell lymphoma (DLBCL) and two cases as post-transplant lymph proliferative disorders (PTLD). 70% had localised disease (I–II). Twelve cases of MALT were treated with antibiotic therapy, followed by chemotherapy or radiotherapy (refractory cases), and two patients were treated solely with antibiotics. DLBCL cases received chemotherapy with an anthracycline-based regimen (recently associated with immunotherapy) and adjuvant radiotherapy in cases of localised disease. PTLD cases were treated with a reduction in immunosuppression and R-CHOP. Only 10 cases (33%) underwent surgery, the last in 2003. Interpretation HP was present in almost all cases of MALT, determining the therapeutic choice. DLBCL were treated systemically with chemotherapy/immunotherapy, followed by adjuvant radiotherapy in localised disease. There has been no indication for surgery in our hospital for this pathology for the past 10 years, and surgery is currently restricted to complications such as perforation and haemorrhage.

Revista do Colégio Brasileiro de Cirurgiões, 1997

Clinical Anatomy, Sep 3, 2018

Lymphadenectomy is a crucial part of the surgical therapy for gastric cancer. The number of norma... more Lymphadenectomy is a crucial part of the surgical therapy for gastric cancer. The number of normal lymph nodes could indicate the number of nodes that need to be retrieved during the procedure. The aim of this study is to analyze the number of lymph nodes in cadavers without gastric cancer according to the Japanese Gastric Cancer Association guidelines. Twenty fresh adult cadavers (14 males, mean age 55, range 24-93 years) were used. Abdominal lymph nodes were dissected and classified according to the Japanese Gastric Cancer Association. For total gastrectomy, the median number of lymph nodes that comprised D1 1 dissection was 27 (range 15-42). The median and mean number of lymph nodes that comprised D2 dissection was 33, ranging from 18 to 50. For distal gastrectomy, the D1 1 level comprised a median of 21 lymph nodes (range 11-38), and the D2 level 22 lymph nodes (range 11-39). In conclusion, considering gastrectomy 1 D2 lymphadenectomy as the standard treatment for gastric cancer, our results show that adequate lymphadenectomy must encompass around 30 lymph nodes. Clin.

Gene, Jul 1, 2017

Please cite this article as: Ana Carolina Anauate, Mariana Ferreira Leal, Fernanda Wisnieski, Leo... more Please cite this article as: Ana Carolina Anauate, Mariana Ferreira Leal, Fernanda Wisnieski, Leonardo Caires Santos, Carolina Oliveira Gigek, Elizabeth Suchi Chen, Jaqueline Cruz Geraldis, Danielle Queiroz Calcagno, Paulo Pimentel Assumpção, Samia Demachki, Carlos Haruo Arasaki, Laércio Gomes Lourenço, Ricardo Artigiani, Rommel Rodríguez Burbano, Marília Arruda Cardoso Smith , Identification of suitable reference genes for miRNA expression normalization in gastric cancer. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Gene(2017), doi: 10.1016/j.gene.2017.04.016

Gastroenterology, May 1, 2010

Relatos de Casos Cirúrgicos, 2018

Transplantation Proceedings, Sep 1, 2021

Cholelithiasis is one of the most prevalent diseases in the general population. Among kidney tran... more Cholelithiasis is one of the most prevalent diseases in the general population. Among kidney transplant (KT) recipients, atypical clinical presentation may delay the diagnosis and proper treatment. This single-center retrospective cohort study compared cholelithiasis clinical presentation and cholecystectomy-associated complications in 230 KT recipients and in 172 members of the general population. KT recipients had a higher proportion of men, comorbidities, biliary pancreatitis, choledocholithiasis, and acute cholecystitis clinical presentations than the general population. KT recipients presented higher American Society of Anesthesiologists scores and higher rates of emergency surgeries (15.7% vs 9.9%, P = .091), conversion (5.7% vs 1.2%, P = .019), drainage (7.8% vs 2.3%, P = .016), postoperative complications (10% vs 4.7%, P = .047), and longer hospital length of stay (1 vs 1 days, interquartile range, 2 vs 0 days; P < .001). There were 5 deaths, all of which occurred in KT recipients. History of diabetes mellitus, renal function, and surgical conversion were independent risk factors associated with postoperative complications. Male sex and level of renal function were independent risk factors associated with postoperative acute cholecystitis. KT was an independent risk factor associated with postoperative choledocholithiasis (adjusted odds ratio, 5.89; 95% confidence interval, 3.03-15.66) and pancreatitis (adjusted odds ratio, 6.89; 95% confidence interval, 2.99-11.61). In conclusion, KT recipients with cholelithiasis have an increased risk for clinical and surgical complications compared with the general population.

Sao Paulo Medical Journal, Jan 3, 2002

A 75-year-old white man was referred to our service complaining of malaise and weight loss for on... more A 75-year-old white man was referred to our service complaining of malaise and weight loss for one year and dysphagia and vomiting for 2 months. The patient had sought out medical consultation as a result of the latter two complaints.

Objective: The authors present a rare manifestations of stromal tumors; an ileal tumor leading to... more Objective: The authors present a rare manifestations of stromal tumors; an ileal tumor leading to intussusception. Material and methods: (Case report), a 39 years old female patient: Present colycky abdominal pain and constipation for 15 days; seven days prior to the admission she had a single episode of diarrhea with blood, physical examination reveled mild pallor; an abdominal mass measuring 10 cm at the right flank. Plain abdominal xray demonstrated a soft tissue mass effect and atypical absence of gas at the right flank. Ct scanning was performed, revealing thickening of the right colon and an image of concentric layers, highly suggestive of intussusception, barium enema confirmed the diagnosis. Treatment: Exploratory laparotomy was performed and surgical findings were compatible with ileocolic intussusception, a right colectomy with resection of the invaginatedilium was done followed by primary anastomosis. Results: Histopathological studies confirmed a 2.4 cm gastro-intestinal stromal tumor (gist), 21 cm from the ileocecal valve compromising only the submucosae. Immunohistochemical test were positive for CD 117 (C-KIT), CD 34, 1a4 and vimentin. Mitotic rate was lower than 5/50 high-power fields (HPF). Discussion: Intussusception occurs rarely in adults (less than 5%) and is responsible for only 1% of the all cases of the obstruction in this group, in 95% of occurrences, etiology is identifiable. Symptoms are related to the location of the tumor. Gastric lesions more often present with bleeding (60-70%).

GED. Gastrenterologia endoscopia digestiva, 2000

GED. Gastrenterologia endoscopia digestiva, 2002

Univ Fed Sao Paulo, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Sao Paulo, SP, BrazilWeb of Scienc

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 2020

Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Associat... more Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of re...