É um repositório para instituições de ensino e investigação produtoras de literatura científica cuja dimensão ainda não justifica a criação de um repositório próprio. Permite integrar instituições, grupos ou indivíduos na infra-estrutura do projecto, nomeadamente através das pesquisas do Portal RCAAP e da B-On.
Chronic Hepatitis C Treated with Peginterferon alfa plus Ribavirin in Clinical Practice - Velosa, J; Serejo, F; Bana, T; Redondo, I; Simão, A; Vale, AM; Pires, S; Macedo, G; Marinho, R; Peixe, P; Sarmento, J; Matos, L; Calinas, F; Carvalho, A; Figueiredo, A
From 1907 patients with chronic hepatitis C proposed for treatment, we analysed 1380 (1124 naive and 256 treatment-experienced) with complete follow-up. Genotype and HCV RNA quantification were assayed by commercial tests. Viremia was considered high if >800,000IU/mL, and low if <400,000IU/mL. Liver fibrosis was staged in 614 patients.
Genotype 1 was the most frequent (60%), followed by 3 (25%), 4 (9%) and 2 (2%); 3.2% had other or unclassified genotype. Genotype 1 was more prevalent in central Portugal and genotype 4 in the south. Viremia was =800,000IU/mL in 54.6% and <400,000IU/mL in 34.6% of the patients, particularly in genotype 2 (p<0.03)...
A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions - Pimentel-Nunes, P; Dinis-Ribeiro, M; Soares, JB; Marcos-Pinto, R; Santos, C; Rolanda, C; Bastos, RP; Areia, M; Afonso, L; Bergman, J; Sharma, P; Gotoda, T; Henrique, R; Moreira-Dias, L
BACKGROUND AND STUDY AIM:
The reliability and external validity of narrow band imaging (NBI) in the stomach have not been described consistently. The aim of the current study was to describe and estimate the accuracy and reliability of a simplified classification system for NBI in the diagnosis of gastric lesions.
Consecutive patients undergoing NBI endoscopy at two reference centers (n=85, 33% with dysplasia) were included in two studies. In total, 224 different areas were biopsied and recorded onto video. In the derivation study, previously described NBI features were analyzed in order to develop a simplified classification. In the validation study the accuracy...
Phenotypic characterization and familial risk in hyperplastic polyposis syndrome - Caetano, AC; Ferreira, H; Soares, J; Ferreira, A; Gonçalves, R; Rolanda, C
Background. Hyperplastic polyposis syndrome (HPS) is a rare condition characterized by numerous hyperplastic polyps (HP) with a pancolonic distribution. Genetic and environmental factors, including smoking, may be responsible for phenotypic differences. Objective. To characterize HPS patients' phenotype and to determine HPS risk and colorectal cancer (CRC) risk in the first-degree relatives (FDRs). Patients and methods. Eight HPS patients were followed at our Gastroenterology Department (2008-2012). The data included (1) macroscopic and histological analysis of polyps, (2) demographic information about patients and their families and (3) colonoscopy results of FDR that accepted a screening exam. Results. Six of the eight index...
Clinical practice in Crohn's disease in bordering regions of two countries: Different medical options, distinct surgical events - Magro, F; Barreiro-de Acosta, M; Lago, P; Carpio, D; Cotter, J; Echarri, A; Gonçalves, R; Pereira, S; Carvalho, L; Lorenzo, A; Barros, L; Castro, J; Dias, JA; Rodrigues, S; Portela, F; Dias, C; Costa-Pereira, A; EIGA; GEDII
Contemplating the multifactorial nature of Crohn's disease (CD), the purpose of this study was to compare two neighbouring CD populations from different nations and examine how clinical characteristics of patients can influence therapeutic strategies and consequently different surgical events in routine clinical practice. Cross-sectional study based on data of an on-line registry of patients with CD in northern Portugal and Galicia. Of the 1238 patients, all with five or more years of disease, 568 (46%) were male and 670 (54%) female. The Portuguese and Galician populations were similar regarding Montreal categories, age at diagnosis, and years of follow-up. Galician B2...
Transvesical endoscopic peritoneoscopy: a novel 5 mm port for intra-abdominal scarless surgery. - Lima, E; Rolanda, C; Pêgo, JM; Henriques-Coelho, T; Silva, D; Carvalho, JL; Correia-Pinto, J
Recently various groups reported successful attempts to perform intra-abdominal surgery through a transgastric pathway. We assessed the feasibility and safety of a novel transvesical endoscopic approach to the peritoneal cavity through a 5 mm port in a porcine model.
MATERIALS AND METHODS:
Transvesical endoscopic peritoneoscopy was performed in 8 anesthetized female pigs, including 3 nonsurvival and 5 survival animals. Under cystoscopic guidance a vesical hole was created on the ventral bladder wall with an open-ended ureteral catheter. An over tube with a luminal diameter of 5.5 mm was placed in the peritoneal cavity, guided by a 0.035-inch guidewire. In all animals we...
Transvesical endoscopic peritoneoscopy: intra-abdominal scarless surgery for urologic applications - Lima, E; Rolanda, C; Correia-Pinto, J
For many abdominal procedures, advantages such as minimal scarring, reduced pain, and faster recovery have made laparoscopy the favored approach over traditional open surgery. The most recent minimally invasive approach is natural orifice transluminal endoscopic surgery (NOTES), which limits morbidity because this surgery does not require incision. This article reviews the history, development, and current and future applications of NOTES in the field of urology.
Experimental foundation for natural orifice transluminal endoscopic surgery and hybrid natural orifice transluminal endoscopic surgery - Lima, E; Rolanda, C; Autorino, R; Correia-Pinto, J
Natural orifice transluminal endoscopic surgery (NOTES) is one of the most exciting concepts that has emerged recently in the surgical field. All accesses to the abdominal cavity in the porcine model using natural orifices, e.g. transgastric, transvesical, transcolonic and transvaginal, have been described and explored. The experimental feasibility of all procedures by NOTES was successfully demonstrated in the porcine model using different types of natural orifices. However, few translations to the human have been made. NOTES is in a developmental stage and much work is still needed to refine techniques, verify safety and document efficacy. This paper is an update...
Peroral esophageal segmentectomy and anastomosis with single transthoracic trocar: a step forward in thoracic NOTES - Rolanda, C; Silva, D; Branco, C; Moreira, I; Macedo, G; Correia-Pinto, J
BACKGROUND AND STUDY AIMS:
A transesophageal natural orifice transluminal endoscopic surgery (NOTES) approach has been proposed for thoracic and mediastinal access. Similarly to transgastric surgery, serious limitations remain related to creating an esophagotomy and its safe closure. A hybrid approach in thoracic NOTES could work as an intermediate step before pure transesophageal NOTES. We assessed the benefit of hybrid thoracic NOTES for peroral segmental esophagectomy and subsequent complete esophageal anastomosis with a single transthoracic port.
Two protocols were used to attempt esophago-esophageal anastomosis: ex vivo using a phantom model (n = 5), and in vivo after esophageal mobilization, and segmental esophagectomy achieved...
Transesophageal pulmonary lobectomy with single transthoracic port assistance: study with survival assessment in a porcine model - Moreira-Pinto, J; Ferreira, A; Miranda, A; Rolanda, C; Correia-Pinto, J
BACKGROUND AND STUDY AIMS:
Thoracoscopic pulmonary lobectomy is being performed in an increasing number of patients. The aims of the current study were to assess natural orifice transluminal endoscopic surgery (NOTES) as an alternative to transthoracic endoscopic surgery, and to test the feasibility of peroral transesophageal right upper pulmonary lobectomy with the assistance of a single transthoracic trocar.
In 10 acute and 4 survival pigs, right upper pulmonary lobectomy was performed using a forward-viewing double-channel gastroscope and an operative thoracoscope with a 5-mm working channel inserted through a single transthoracic 12-mm) port. Time, safety, and feasibility of the following steps were recorded...
Left atrial appendage ligation with single transthoracic port assistance: a study of survival assessment in a porcine model - Moreira-Pinto, J; Ferreira, A; Miranda, A; Rolanda, C; Correia-Pinto, J
Left atrial appendage (LAA) exclusion is a well-known procedure for the prevention of stroke in high-risk patients with atrial fibrillation and contraindication to long-term oral anticoagulant therapy.
To evaluate a natural orifice transluminal endoscopic surgery (NOTES) approach for LAA ligation.
In 4 acute and 6 survival pigs, we performed LAA by using a forward-viewing, single-channel gastroscope and an operative thoracoscope with a 3-mm working channel (introduced through an 8-mm single transthoracic port).
The gastroscope was introduced in the thoracic cavity through an esophageal submucosal tunnel. An end loop introduced through the gastroscope was used to legate the LAA. In the survival experiments,...
Decisões clínicas na doença de Crohn - Magro, F; Correia, L; Lago, P; Macedo, G; Peixe, P; Portela, F; Ferreira, A; Gonçalves, R; et al
Introduction: Crohn s disease is a chronic inflammatory disease from gastrointestinal tract. The increase in incidence and heterogeneity of this pathology, with different presentations and prognostics leads to a constant concern in developing and improving its classification and treatment.
Objectives: To establish recommendations (based on level of evidence and recommendation grades) to 5 questions considered as the clinical challenges of the therapeutic approach in Crohn s disease.
Methods: The methodology adopted by the working group DC2 (Desafios Clínicos na Doença de Crohn) was based on the selection of 5 questions, by voting, and establishing recommendations to each question proposed to each subgroup....
Colecistectomia Videolaparoscópica Transumbilical Single Site com Equipamento de Laparoscopia Convencional - Rolanda, C
artigo intitulado Colecistectomia videolaparoscópica transumbilical (single site) com equipamento de laparoscopia convencional recentemente publicado por Alves Júnior e colaboradores mereceu-nos atenção e algumas considerações que gostaria de partilhar. Embora aborde uma temática tradicionalmente adstrita à Cirurgia Geral, vale a pena revisitar alguns conceitos e perceber o contexto actual da cirurgia minimamente invasiva (MIS), onde também temos lugar enquanto gastrenterologistas.
Natural orifice transesophageal endoscopic surgery: state of the art - Moreira-Pinto, J; Ferreira, A; Rolanda, C; Correia-Pinto, J
The main goal of Natural Orifice Transluminal Endoscopic Surgery (NOTES) is performing surgery avoiding skin incisions. Theoretical advantages of NOTES include decreased postoperative pain, reduction/elimination of general anesthesia, improved cosmetic outcomes, elimination of skin incision-related complications such as wound infections and hernias, and increased overall patient satisfaction. Although various forms of port creation to accomplish thoracic NOTES procedures have been proposed, transesophageal NOTES has been shown to be the most reliable one. The evolution of endoscopic submucosal transesophageal access resulted in the development of per-oral endoscopic myotomy (POEM), which had a fast transition to clinical practice. The authors present a...
Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery - Lima, E; Henriques-Coelho, T; Rolanda, C; Pêgo, JM; Silva, D; Carvalho, JL; Correia-Pinto, J
Recently there has been an increasing enthusiasm for using natural orifices translumenal endoscopic surgery (NOTES) to perform scarless abdominal procedures. We have previously reported the feasibility and safety of the transvesical endoscopic peritoneoscopy in a long-term survival porcine model as useful for those purposes. Herein, we report our successful experience performing transvesical and transdiaphragmatic endoscopic approach to the thoracic cavity in a long-term survival study in a porcine model.
Transvesical and transdiaphragmatic endoscopic thoracoscopy was performed in six anesthetized female pigs. A 5 mm transvesical port was created on the bladder wall and an ureteroscope was advanced into the peritoneal cavity....