|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Does autologous blood transfusion during liver transplantation for hepatocellular carcinoma increase risk of recurrence?显示文摘AIM: To analyze outcomes in patients who underwent liver transplantation(LT) for hepatocellular carcinoma(HCC) and received autologous intraoperative blood salvage(IBS). METHODS: Consecutive HCC patients who underwent LT were studied retrospectively and analyzed according to the use of IBS or not. Demographic and surgical data were collected from a departmental prospective maintained database. Statistical analyses were performed using the Fisher's exact test and the Wilcoxon rank sum test to examine covariate differences between patients who underwent IBS and those who did not. Univariate and multivariate Cox regression models were developed to evaluate recurrence and death,and survival probabilities were estimated using the Kaplan-Meier method and compared by the log-rank test.RESULTS: Between 2002 and 2012,158 consecutive patients who underwent LT in the same medical center and by the same surgical team were identified. Among these patients,122(77.2%) were in the IBS group and 36(22.8%) in the non-IBS group. The overall survival(OS) and recurrence free survival(RFS) at 5 years were 59.7% and 83.3%,respectively. No differences in OS(P=0.51) or RFS(P=0.953) were detected between the IBS and non-IBS groups. On multivariate analysis for OS,degree of tumor differentiation remained as the only independent predictor. Regarding patients who received IBS,no differences were detected in OS or RFS(P=0.055 and P=0.512,respectively) according to the volume infused,even when outcomes at 90 d or longer were analyzed separately(P=0.518 for both outcomes).CONCLUSION: No differences in RFS or OS were detected according to IBS use. Trials addressing this question are justified and should be designed to detect small differences in long-term outcomes. | Raphael LC Araujo Carlos Andrés Pantanali Luciana Haddad Joel Avancini Rocha Filho Luiz Augusto Carneiro D’Albuquerque Wellington Andraus | 2016 | World Journal of Gastrointestinal Surgery2016，8，2： | 14 |
| 2 | Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis显示文摘AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis. | Giliane Belarmino Maria Cristina Gonzalez Raquel S Torrinhas Priscila Sala Wellington Andraus Luiz Augusto Carneiro D'Albuquerque Rosa Maria R Pereira Valéria F Caparbo Graziela R Ravacci Lucas Damiani Steven B Heymsfield Dan L Waitzberg | 2017 | World Journal of Hepatology2017，9，7： | 11 |
| 3 | Pre-and postoperative systemic hemodynamic evaluation in patients subjected to esophagogastric devascularization plus splenectomy and distal splenorenal shunt:A comparative study in schistomomal portal hypertension显示文摘AIM: To investigate the systemic hemodynamic effects of two surgical procedures largely employed for treatment of schistosomal portal hypertension. METHODS: Thirty-six patients undergoing elective surgical treatment of portal hypertension due to hepatosplenic mansonic schistosomiasis were prospectively evaluated. All patients were subjected to preoperative pulmonary artery catheterization; 17 were submitted to esophagogastric devascularization and splenectomy (EGDS) and 19 to distal splenorenal shunt (DSRS). The systemic hemodynamic assessment was repeated 4 d after the surgical procedure. RESULTS: Preoperative evaluation revealed (mean ± SD) an increased cardiac index (4.78 ± 1.13 L/min per m2),associated with a reduction in systemic vascular resistance index (1457 ± 380.7 dynes.s/cm5.m2). The mean pulmonary artery pressure (18 ± 5.1 mmHg) as well as the right atrial pressure (7.9 ± 2.5 mmHg) were increased,while the pulmonary vascular resistance index (133 ± 62 dynes.s/cm5.m2) was decreased. Four days after EGDS,a significant reduction in cardiac index (3.80 ± 0.4 L/min per m2,P < 0.001) and increase in systemic vascular resistance index (1901.4 ± 330.2 dynes.s/cm5. m2,P < 0.001) toward normal levels were observed. There was also a significant reduction in pulmonary artery pressure (12.65 ± 4.7 mmHg,P < 0.001) and no significant changes in the pulmonary vascular resistance index (141.6 ± 102.9 dynes.s/cm5.m2). Four days after DSRS,a non-significant increase in cardiac index (5.2 ± 0.76 L/min per m2) and systemic vascular resistance index (1389 ± 311 dynes.s/cm5.m2) was observed. There was also a non-significant increase in pulmonary artery pressure (19.84 ± 5.2 mmHg),right cardiac work index (1.38 ± 0.4 kg.m/m2) and right ventricular systolic work index (16.3 ± 6.3 g.m/m2),without significant changes in the pulmonary vascular resistance index (139.7 ± 67.8 dynes.s/cm5.m2). CONCLUSION: The hyperdynamic circulatory state observed in mansonic schistosomiasis was corrected by EGDS,but was maintained in patients who underwent DSRS. Similarly,the elevated mean pulmonary artery pressure was corrected after EGDS and maintained after DSRS. EGDS seems to be the most physiologic surgery for patients with schistosomal portal hypertension. | Roberto de Cleva Paulo Herman Luis Augusto Carneiro D’albuquerque Vincenzo Pugliese Orlando Luis Santarem William Abro Saad | 2007 | World Journal of Gastroenterology2007，13，41： | 9 |
| 4 | Liver transplantation:Fifty years of experience显示文摘Since 1963,when the first human liver transplantation(LT)was performed by Thomas Starzl,the world has witnessed 50 years of development in surgical techniques,immunosuppression,organ allocation,donor selection,and the indications and contraindications for LT.This has led to the mainstream,wellestablished procedure that has saved innumerable lives worldwide.Today,there are hundreds of liver transplant centres in over 80 countries.This review aims to describe the main aspects of LT regarding the progressive changes that have occurred over the years.We herein review historical aspects since the first experimental studies and the first attempts at human transplantation.We also provide an overview of immunosuppressive agents and their potential side effects,the evolution of the indications and contraindications of LT,the evolution of survival according to different time periods,and the evolution of methods of organ allocation. | Alice Tung Wan Song Vivian Iida Avelino-Silva Rafael Antonio Arruda Pecora Vincenzo Pugliese Luiz Augusto Carneiro D'Albuquerque Edson Abdala | 2014 | World Journal of Gastroenterology2014，20，18： | 8 |
| 5 | Hepatic ischemic preconditioning increases portal vein flow in experimental liver ischemia reperfusion injury显示文摘BACKGROUND: Ischemic preconditioning(IPC) has been shown to decrease liver injury and to increase hepatic microvascular perfusion after liver ischemia reperfusion. This study aimed to evaluate the effects of IPC on hemodynamics of the portal venous system. METHODS: Thirty-two rats were randomized into two groups: IPC group and control group. The rats of the IPC group underwent IPC by 10 minutes of liver ischemia followed by 10 minutes of reperfusion before liver ischemia, and the rats of the control group were subjected to 60 minutes of partial liver ischemia. Non-ischemic lobes were resected immediately after reperfusion. The animals were studied at 4 hours and 12 hours after reperfusion. Mean arterial pressure, heart rate, portal vein flow and pressure were analyzed. Blood was collected for the determination of the levels of aspartate aminotransferase, alanine aminotransferase, calcium, lactate, pH, bicarbonate, and base excess. RESULTS: IPC increased the mean portal vein flow at 4 hours and 12 hours after reperfusion. IPC recovered 78% of the meanportal vein flow at 12 hours after reperfusion. IPC decreased the levels of aspartate aminotransferase, alanine aminotransferase and lactate, and increased the levels of ionized calcium, bicarbonate and base excess at 12 hours after reperfusion. CONCLUSIONS: This study demonstrated that IPC increases portal vein flow and enhances hepatoprotective effects in liver ischemia reperfusion. The better recovery of portal vein flow after IPC may be correlated with the lower levels of transaminases and with the better metabolic profile. | Estela RR Figueira Joel A Rocha-Filho Mauro Nakatani Marcelo FS Buto Eduardo R Tatebe Vitor O Andre Ivan Cecconello Luiz AC D'Albuquerque | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，1： | 6 |
| 6 | Percutaneous radiofrequency ablation for early hepatocellular carcinoma: Risk factors for survival显示文摘AIM: To evaluate outcomes of radiofrequency ablation(RFA) therapy for early hepatocellular carcinoma(HCC) and identify survival- and recurrence-related factors. METHODS: Consecutive patients diagnosed with early HCC by computed tomography(CT) or magnetic resonance imaging(MRI)(single nodule of ≤ 5 cm, or multi-(up to 3) nodules of ≤ 3 cm each) and who underwent RFA treatment with curative intent between January 2010 and August 2011 at the Instituto do Cancer do Estado de S o Paulo, Brazil were enrolled in the study. RFA of the liver tumors(with 1.0 cm ablative margin) was carried out under CT-fluoro scan and ultrasonic image guidance of the percutaneous ablation probes. Procedure-related complications were recorded. At 1-mo post-RFA and 3-mo intervals thereafter, CT and MRI were performed to assess outcomes of complete response(absence of enhancing tissue at the tumor site) or incomplete response(enhancing tissue remaining at the tumor site). Overall survival and diseasefree survival rates were estimated by the Kaplan-Meier method and compared by the log rank test or simple Cox regression. The effect of risk factors on survival was assessed by the Cox proportional hazard model. RESULTS: A total of 38 RFA sessions were performed during the study period on 34 patients(age in years: mean, 63 and range, 49-84). The mean follow-up time was 22 mo(range, 1-33). The study population showed predominance of male sex(76%), less severe liver disease(Child-Pugh A, n = 26; Child-Pugh B, n = 8), and single tumor(65%). The maximum tumor diameters ranged from 10 to 50 mm(median, 26 mm). The initial(immediately post-procedure) rate of RFAinduced complete tumor necrosis was 90%. The probability of achieving complete response was significantly greater in patients with a single nodule(vs patients with multi-nodules, P = 0.04). Two patients experienced major complications, including acute pulmonary edema(resolved with intervention) and intestinal perforation(led to death). The 1- and 2-year overall survival rates were 82% and 71%, respectively. Sex, tumor size, initial response, and recurrence status influenced survival, but did not reach the threshold of statistical significance. Child-Pugh class and the model for end-stage liver disease score were identified as predictors of survival by simple Cox regression, but only Child-Pugh class showed a statistically significant association to survival in multiple Cox regression analysis(HR = 15; 95%CI: 3-76 mo; P = 0.001). The 1-and 2-year cumulative disease-free survival rates were 65% and 36%, respectively. CONCLUSION: RFA is an effective therapy for local tumor control of early HCC, and patients with preserved liver function are the best candidates. | Luciana Kikuchi Marcos Menezes Aline L Chagas Claudia M Tani Regiane SSM Alencar Marcio A Diniz Venncio AF Alves Luiz Augusto Carneiro D’Albuquerque Flair José Carrilho | 2014 | World Journal of Gastroenterology2014，20，6： | 5 |
| 7 | Pentoxifylline enhances the protective effects of hypertonic saline solution on liver ischemia reperfusion injury through inhibition of oxidative stress显示文摘BACKGROUND:Liver ischemia reperfusion(IR)injury triggers a systemic inflammatory response and is the main cause of organ dysfunction and adverse postoperative outcomes after liver surgery.Pentoxifylline(PTX)and hypertonic saline solution(HTS)have been identified to have beneficial effects against IR injury.This study aimed to investigate if the addition of PTX to HTS is superior to HTS alone for the prevention of liver IR injury. | Vinicius Rocha-Santos Estela RR Figueira Joel A Rocha-Filho Ana MM Coelho Rafael Soraes Pinheiro Telesforo Bacchella Marcel CC Machado Luiz AC D'Albuquerque | 2015 | Hepatobiliary & Pancreatic Diseases International2015，14，2： | 3 |
| 8 | Preservation of platelet function in patients with cirrhosis and thrombocytopenia undergoing esophageal variceal ligation显示文摘Background:Thrombocytopenia is a possible risk factor for bleeding after band ligation of esophageal varices.However,elevated von Willebrand factor(VWF)in cirrhosis improves platelet function and could decrease this risk.Our objective was to assess platelet function in patients with cirrhosis undergoing esophageal variceal ligation(EVL).Methods:The assessment consisted of platelet count,antigen and activity of VWF and VWF-cleaving protease ADAMTS-13 activity,and a platelet adhesion and aggregation test simulating vascular flow in vivo(Impact-RR)prior to EVL.Results:Totally 111 patients were divided into three groups according to platelet count:(1)<50×109/L(n=38,34.2%);(2)50×109/L to 100×109/L(n=47,42.3%);and(3)>100×109/L(n=26,23.4%).No statistically significant difference was found in the aggregate size of platelets[group 1:41.0(31.8–67.3)μm 2;group 2:47.0(33.8–71.3)μm 2;and group 3:47.0(34.0–66.0)μm 2;P=0.60]and no significant correlation was found between aggregate size and platelet count(Spearman r=0.07;P=0.47).Surface coverage was 4.1%(2.8%–6.7%),8.5%(4.0%–10.0%),and 9.0%(7.1%–12.0%)(P<0.001)in groups 1,2 and 3,respectively and correlated with platelet count(Spearman r=0.39;P<0.0001).There was no significant difference between groups in VWF or ADAMTS-13.Post-EVL bleeding occurred in six(5.4%)patients(n=2 in group 1,n=1 in group 2,and n=3 in group 3;P=0.32).Patients with bleeding had higher MELD scores[15.0(11.3–20.3)versus 12.0(10.0–15.0);P=0.025],but no difference was demonstrated for platelet function parameters.Conclusion:Platelet function is preserved even in the presence of thrombocytopenia,including in the patients with post-EVL bleeding. | Evandro de Oliveira Souza Elbio Antonio D’Amico Tania Rubia Flores da Rocha Caroline Marcondes Ferreira Juliana Medeiros Batista Luiz Augusto CarneiroD’Albuquerque Flair Jose Carrilho Alberto Queiroz Farias | 2020 | Hepatobiliary & Pancreatic Diseases International2020，19，6： | 3 |
| 9 | Pentoxifylline 通过 TNF- 合成和 TGF-1 基因表示的下面规定改进肝新生显示文摘 AIM:To investigate the mechanism of pentoxifylline(PTX)improvement in liver regeneration.RESULTS:Rats were randomized into 4 groups:Control rats;Sham-sham-operation rats;Saline-70% hepatectomy plus saline solution;PTX-70%hepatectomy plus PTX.At 2 and 6 h after hepatectomy,aspartate aminotransferase,alanine aminotransferase,tumor necrosis factor(TNF)-α and interleukin-6(IL-6)serum and hepatic tissue levels were determined.Tumor growth factor(TGF)-β1 gene expression in liver tissue was evaluated 24 h after hepatectomy by quantitative reverse transcriptase polymerase chain reaction analysis.Proliferation was analyzed by mitotic index and proliferating cell nuclear antigen(PCNA)staining 48 h after hepatectomy.RESULTS:TNF-α and IL-6 serum levels increased at 2 and 6 h after hepatectomy.At 2 h after hepatectomy serum PTX was reduced but not hepatic levels of TNF-α and IL-6.A decrease in liver TGF-β1 gene expression and an increase in mitotic index and PCNA after hepatectomy were observed in the PTX treatment group in comparison to the saline group.CONCLUSION:PTX improves liver regeneration by a mechanism related to down regulation of TNF-α production and TGF-β1 gene expression. | Rodrigo Bronze Martino Ana Maria Mendona Coelho Márcia Saldanha Kubrusly Regina Leito Sandra Nassa Sampietre Marcel Cerqueira Cesar Machado Telesforo Bacchella Luiz Augusto Carneiro D’Albuquerque | 2012 | World Journal of Gastrointestinal Surgery2012，4，6： | 2 |
| 10 | Beneficial effects of adenosine triphosphate-sensitive K^+ channel opener on liver ischemia/reperfusion injury显示文摘AIM:To investigate the effect of diazoxide administration on liver ischemia/reperfusion injury.METHODS:Wistar male rats underwent partial liver ischemia performed by clamping the pedicle from the medium and left anterior lateral segments for 1 h under mechanical ventilation.They were divided into 3 groups:Control Group,rats submitted to liver manipulation,Saline Group,rats received saline,and Diazoxide Group,rats received intravenous injection diazoxide(3.5 mg/kg) 15 min before liver reperfusion.4 h and 24 h after reperfusion,blood was collected for determination of aspartate transaminase(AST),alanine transaminase(ALT),tumor necrosis factor(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10),nitrite/nitrate,creatinine and tumor growth factor-β1(TGF-β1).Liver tissues were assembled for mitochondrial oxidation and phosphorylation,malondialdehyde(MDA) content,and histologic analysis.Pulmonary vascular permeability and myeloperoxidase(MPO) were also determined.RESULTS:Four hours after reperfusion the diazoxide group presented with significant reduction of AST(2009 ± 257 U/L vs 3523 ± 424 U/L,P = 0.005); ALT(1794 ± 295 U/L vs 3316 ± 413 U/L,P = 0.005); TNF-α(17 ± 9 pg/mL vs 152 ± 43 pg/mL,P = 0.013; IL-6(62 ± 18 pg/mL vs 281 ± 92 pg/mL); IL-10(40 ± 9 pg/mL vs 78 ± 10 pg/mL P = 0.03),and nitrite/nitrate(3.8 ± 0.9 μmol/L vs 10.2 ± 2.4 μmol/L,P = 0.025) when compared to the saline group.A significant reduction in liver mitochondrial dysfunction was observed in the diazoxide group compared to the saline group(P < 0.05).No differences in liver MDA content,serum creatinine,pulmonary vascular permeability and MPO activity were observed between groups.Twenty four hours after reperfusion the diazoxide group showed a reduction of AST(495 ± 78 U/L vs 978 ± 192 U/L,P = 0.032); ALT(335 ± 59 U/L vs 742 ± 182 U/L,P = 0.048),and TGF-β1(11 ± 1 ng/mL vs 17 ± 0.5 ng/mL,P = 0.004) serum levels when compared to the saline group.The control group did not present alterations when compared to the diazoxide and saline groups.CONCLUSION:Diazoxide maintains liver mitochondrial function,increases liver tolerance to ischemia/reperfusion injury,and reduces the systemic inflammatory response.These effects require further evaluation for using in a clinical setting. | Mateus Antunes Nogueira Ana Maria Mendona Coelho Sandra Nassa Sampietre Rosely Antunes Patzina Fabiano Pinheiro da Silva Luiz Augusto Carneiro D'Albuquerque Marcel Cerqueira Cesar Machado | 2014 | World Journal of Gastroenterology2014，20，41： | 2 |
| 11 | Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review显示文摘AIM: To perform a systematic review focusing on shortterm outcomes after colorectal surgery in patients with previous abdominal open surgery(PAOS).METHODS: A broad literature search was performed with the terms 'colorectal', 'colectomy', 'PAOS', 'previous surgery' and 'PAOS'. Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS, whether descriptive or comparative. Endpoints of interest were conversion rates, inadvertent enterotomy and morbidity. Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.RESULTS: From a total of 394 citations, 13 full-texts achieved selection criteria to be included in the study. Twelve of them compared patients with and without PAOS. All studies were retrospective and comparative and two were case-matched. The selected studies comprised a total of 5005 patients, 1865 with PAOS. Among the later, only 294(16%) had history of a midline incision for previous gastrointestinal surgery. Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopywas more prevalent in 3 of 5 studies that disclosed this event. Morbidity was similar in the majority of studies. A quantitative analysis(meta-analysis) could not be performed due to heterogeneity of the studies. CONCLUSION: Conversion rates were slightly higher in PAOS groups, although not statistical significant in most studies. History of PAOS did not implicate in higher morbidity rates. | Marleny Novaes Figueiredo Fabio Guilherme Campos Luiz Augusto D'Albuquerque Sergio Carlos Nahas Ivan Cecconello Yves Panis | 2016 | World Journal of Gastrointestinal Surgery2016，8，7： | 2 |
| 12 | A reappraisalof angioplastyand stenting for the treatment of vertebral origin 8tenosis显示文摘 | Albuquerque FC Fiorella D Han P | 2003 | Neurosurgery2003，53，3： | 1 |
| 13 | Transesterification of ethyl butyrate with methanol using MgO/CaOcatalyst 显示文摘 | ALBUQUERQUE M C G AZEVEDO D C S CAVALCANTE C L | 2009 | Journal of Molecular Catalysis A : Chemical2009，300，12： | 1 |
| 14 | Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms显示文摘 | Fiorella D Albuquerque FC Han P | 2004 | Neurosurgery2004，54，1： | 1 |
| 15 | Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms 显示文摘 | Fiorella D Albuquerque FC Han P | 2004 | Neurosurgery2004，54，1： | 1 |
| 16 | Neuroform in-stent stenosis: incidence, natural history, and treatment strategies 显示文摘 | Fiorella D Albuquerque FC Woo H | 2006 | Neurosurgery2006，59，1： | 1 |
| 17 | Use of the splenic artery for arterial reconstruction in living donor liver transplantation显示文摘 | D' Albuquerque LA Gonzatez AM Letrinda RF | 2007 | Transplant Proc2007，39，53： | 1 |
| 18 | Usefulness of the Neuroform stent for the treatment of cerebral aneurysms: results at initial (3-6-mo) follow-up显示文摘 | FIWRELLA D ALBUQUERQUE F C DESHMUKH V R | 2005 | Neurosurgery2005，56，6： | 1 |
| 19 | Radiation-related predictors of hematologic toxicity after concurrent chemoradiation for cervical cancer and implications for bone marrow-sparing pelvic IMRT显示文摘 | Albuquerque K Giangreco D Morrison C | 2011 | Int J Radiat Oncol Biol Phys2011，79，4： | 1 |
| 20 | Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms 显示文摘 | Fiorella D Albuquerque FC Han P | 2004 | Neurosurgery2004，54，1： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员