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| 1 | Laparoscopic liver resection:Experience based guidelines显示文摘Laparoscopic liver resection(LLR) has been progressively developed along the past two decades. Despite initial skepticism, improved operative results made laparoscopic approach incorporated to surgical practice and operations increased in frequency and complexity. Evidence supporting LLR comes from case-series, comparative studies and meta-analysis. Despite lack of level 1 evidence, the body of literature is stronger and existing data confirms the safety, feasibility and benefits of laparoscopic approach when compared to open resection. Indications for LLR do not differ from those for open surgery. They include benign and malignant(both primary and metastatic) tumors and living donor liver harvesting. Currently, resection of lesions located on anterolateral segments and left lateral sectionectomy are performed systematically by laparoscopy in hepatobiliary specialized centers. Resection of lesions located on posterosuperior segments(1, 4a, 7, 8) and major liver resections were shown to be feasible but remain technically demanding procedures, which should be reserved to experienced surgeons. Hand-assisted and laparoscopy-assisted procedures appeared to increase the indications of minimally invasive liver surgery and are useful strategies applied to difficult and major resections. LLR proved to be safe for malignant lesions and offers some short-term advantages over open resection. Oncological results including resection margin status and long-term survival were not inferior to open resection. At present, surgical community expects high quality studies to base the already perceived better outcomes achieved by laparoscopy in major centers' practice. Continuous surgical training, as well as new technologies should augment the application of lap-aroscopic liver surgery. Future applicability of new technologies such as robot assistance and image-guided surgery is still under investigation. | fabricio ferreira coelho jaime arthur pirola kruger gilton marques fonseca raphael leonardo cunha araújo vagner birk jeismann marcos vinícius perini renato micelli lupinacci ivan cecconello paulo herman | 2016 | World Journal of Gastrointestinal Surgery2016，8，1： | 22 |
| 2 | Biliary tract schwannoma:A rare cause of obstructive jaundice in a young patient显示文摘Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastro-intestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumordid not recur in any of the resected cases. | Gilton Marques Fonseca André Luis Montagnini Manoel de Souza Rocha Rosely Antunes Patzina Mário Vinícius Angelete Alvarez Bernardes Ivan Cecconello José Jukemura | 2012 | World Journal of Gastroenterology2012，18，37： | 10 |
| 3 | 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 |
| 4 | Gastric partitioning for the treatment of malignant gastric outlet obstruction显示文摘BACKGROUND Gastric outlet obstruction(GOO)is one of the main complications in stage IV gastric cancer patients.This condition is usually managed by gastrojejunostomy(GJ).However,gastric partitioning(GP)has been described as an alternative to overcoming possible drawbacks of GJ,such as delayed gastric emptying and tumor bleeding.AIM To compare the outcomes of patients who underwent GP and GJ for malignant GOO.METHODS We retrospectively analyzed 60 patients who underwent palliative gastric bypass for unresectable distal gastric cancer with GOO from 2009 to 2018.Baseline clinicopathological characteristics including age,nutritional status,body mass index,and performance status were evaluated.Obstructive symptoms were graded according to GOO score(GOOS).Surgical outcomes evaluated included duration of the procedure,surgical complications,mortality,and length of hospital stay.Acceptance of oral diet after the procedure,weight gain,and overall survival were the long-term outcomes evaluated.RESULTS GP was performed in 30 patients and conventional GJ in the other 30 patients.The mean follow-up was 9.2 mo.Forty-nine(81.6%)patients died during that period.All variables were similar between groups,with the exception of worse performance status in GP patients.The mean operative time was higher in the GP group(161.2 vs 85.2 min,P<0.001).There were no differences in postoperative complications and surgical mortality between groups.The median overall survival was 7 and 8.4 mo for the GP and GJ groups,respectively(P=0.610).The oral acceptance of soft solids(GOOS 2)and low residue or full diet(GOOS 3)were reached by 28(93.3%)GP patients and 22(75.9%)GJ patients(P=0.080).Multivariate analysis demonstrated that GOOS 2 and GOOS 3 were the main prognostic factors for survival(hazard ratio:8.90,95%confidence interval:3.38-23.43,P<0.001).CONCLUSION GP is a safe and effective procedure to treat GOO.Compared to GJ,it provides similar surgical outcomes with a trend to better solid diet acceptance by patients. | Marcus Fernando Kodama Pertille Ramos Leandro Cardoso Barchi Rodrigo Jose de Oliveira Marina Alessandra Pereira Donato Roberto Mucerino Ulysses Ribeiro Jr Bruno Zilberstein Ivan Cecconello | 2019 | World Journal of Gastrointestinal Oncology2019，11，12： | 2 |
| 5 | 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 |
| 6 | Absence of Lymph Nodes in the Resected Specimen After Radical Surgery for Distal Rectal Cancer and Neoadjuvant Chemoradiation Therapy: What does it Mean?显示文摘 | Angelita Habr-Gama M.D. Ph.D. Rodrigo O. Perez M.D. Ph.D. Igor Proscurshim M.S. Viviane Rawet M.D. Ph.D. Diego D. Pereira M.S. Afonso H. S. Sousa M.D. Ph.D. Desiderio Kiss M.D. Ph.D. Ivan Cecconello M.D. Ph.D | 2008 | Diseases of the Colon & Rectum2008，，3： | 2 |
| 7 | Repeat hepatectomy for recurrent colorectal liver metastases:A comparative analysis of short-and long-term results显示文摘Background: Liver recurrence after resection of colorectal liver metastases(CRLM) is frequent. Repeat hepatectomy has been shown to have satisfactory perioperative results. However, the long-term outcomes and the benefts for patients with early recurrence have not been clarifed. The aim of this study was to compare the short-and long-term outcomes of patients undergoing single hepatectomy and repeat hepatectomy for CRLM. Additionally, the oncological outcomes of patients with early( ≤ 6 months) and late recurrence who underwent repeat hepatectomy were compared. Methods: Consecutive adult patients undergoing hepatectomy for CRLM between June 20 0 0 and February 2020 were included and divided into two groups: single hepatectomy and repeat hepatectomy. Results: A total of 709 patients were included: 649 in the single hepatectomy group and 60 in the repeat hepatectomy group. Patients in the repeat hepatectomy group underwent more cycles of preoperative chemotherapy [4(3-6) vs. 3(2-4), P = 0.003]. Patients in the single hepatectomy group more frequently underwent major hepatectomies(34.5% vs. 16.7%, P = 0.004) and had a greater number of lesions resected(2.9 ± 3.6 vs. 1.9 ± 1.8, P = 0.011). There was no increase in operative time, estimated blood loss, length of hospital stay, complications, or mortality in the repeat hepatectomy group. There were no differences in overall survival( P = 0.626) and disease-free survival( P = 0.579) between the two groups. Similarly, for patients underwent repeat hepatectomy, no difference was observed between the early and late recurrence groups in terms of overall survival( P = 0.771) or disease-free survival( P = 0.350). Conclusions: Repeat hepatectomy is feasible and safe, with similar short-and long-term outcomes when compared to single hepatectomy. Surgical treatment of early liver recurrence offers similar oncological outcomes to those obtained for late recurrence. | Paulo Figueiredo Costa Fabricio Ferreira Coelho Vagner Birk Jeismann Jaime Arthur Pirola Kruger Gilton Marques Fonseca Ivan Cecconello Paulo Herman | 2022 | Hepatobiliary & Pancreatic Diseases International2022，21，2： | 2 |
| 8 | Transanal endoscopic microsurgery: indications, results and controversies显示文摘 | Andre Roncon Dias Caio Sergio Rizkallah Nahas Carlos Frederico Sparapan Marques Sergio Carlos Nahas Ivan Cecconello | 2009 | Techniques in Coloproctology2009，，2： | 1 |
| 9 | Gastric cancer trends in ep- idemiology 显示文摘 | Zilberstein B Jacob CE Cecconello I | 2012 | Arq Gastroentero12012，49，3： | 1 |
| 10 | Sexual hormones and erectile function more than 6 years after hariatric sur- gery显示文摘 | Rosenblatt A Faintuch J Cecconello I | 2013 | Surg Obes Relat Dis2013，9，5： | 1 |
| 11 | Gastric cancer trends in epidemiology显示文摘 | Zilberstein 3 Jacob CE Cecconello I | 2012 | Arq Gastroenterol2012，49，3： | 1 |
| 12 | Molecular aspects of esophageal squamous cell carcinoma carcinogenesis显示文摘 | Lehrbach DM Nita ME Cecconello I | 2003 | Arq Gastroenterol2003，40，4： | 1 |
| 13 | Effect of the current density on morphology, porosity, and tribological properties of leetrodeposited nickel on copper 显示文摘 | Vanessa F C Lins Erik S Cecconello Tulio Matencio | 2008 | Journal of Materials Engineering and Performance2008，17，5： | 1 |
| 14 | Endoscopic Detection of Early Esophageal Squamous Cell Carcinoma in Patients with Achalasia: Narrow-Band Imaging versus Lugol’s Staining显示文摘 | Edson Ide Fred Olavo Arag?o Andrade Carneiro Mariana Souza Varella Fraz?o Dalton Marques Chaves Rubens Ant?nio Aissar Sallum Eduardo Guimar?es Hourneaux de Moura Paulo Sakai Ivan Cecconello Fauze Maluf-Filho Everson L. A. Artifon | 2013 | Journal of Oncology2013，，： | 1 |
| 15 | Postoperative chest physical therapy prevents respiratory comp- lications in patients undergoing esophagectomy 显示文摘 | Lunardi A C Cecconello I Carvalho C R | 2011 | Rev Bras Fisioter2011，15，2： | 1 |
| 16 | Postoperative Chest Physical Therapy Prevents Respiratory Complications in Patients Undergoing Esophagectomy显示文摘 | Lunardi A C Cecconello I Carvalho C R | 2011 | Rev Bras Fi- sioter2011，15，2： | 1 |
| 17 | Endoscopic Sphincterotomy Before Deployment of Covered Metal Stent is Associated With Greater Complication Rate: A Prospective Randomized Control Trial显示文摘 | Everson L. A. Artifon Paulo Sakai Shinichi Ishioka Sérgio B. Marques André S. Lino José E. M. Cunha José Jukemura Ivan Cecconello Flair J. Carrilho Eduardo Opitz Atul Kumar | 2008 | Journal of Clinical Gastroenterology2008，，7： | 1 |
| 18 | Refractory and new-onset diabetes more than 5?years after gastric bypass for morbid obesity显示文摘 | Camila Yamaguchi Joel Faintuch Silvia Hayashi Jacob Faintuch Ivan Cecconello | 2012 | Surgical Endoscopy2012，，10： | 1 |
| 19 | Proliferative diabetic retinopathy is related to cardiovascular autonomic neuropathy in non-insulin-dependent diabetes mellitus显示文摘 | Schmid H Schaan B Cecconello F | 1995 | Diabetes Res Clin Pract1995，29，： | 1 |
| 20 | Laparoscopic total mesorectal excision: early and late results 显示文摘 | Cecconello I Araujo SE Seid VE | 2011 | Asian J Endosc Surg2011，4，3： | 1 |
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