VITOR OTTOBONI BRUNALDI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0?(2023) BRUNALDI, Vitor Ottoboni; OLIVEIRA, Guilherme Henrique Peixoto de; KERBAGE, Anthony; RIBAS, Pedro Henrique; NUNES, Felipe; FARIA, Galileu; MOURA, Diogo de; RICCIOPPO, Daniel; SANTO, Marco; MOURA, Eduardo deBackground and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the short term. However, no study has investigated the course of gastrojejunostomy (GJ) or quality of life (QOL) data after the first post-procedure year.Patients and methods Patients eligible for a 36-month follow-up visit after TORe underwent upper gastrointestinal endoscopy with measurement of the GJ and answered QOL questionnaires (RAND-36). The primary aim was to evaluate the long-term outcomes of TORe, including weight loss, QOL, and GJ anastomosis (GJA) size. Comparisons between APC and APC-FTS TORe were a secondary aim.Results Among 39 eligible patients, 29 returned for the 3-year follow-up visit. There were no significant differences in demographics between APC and APC-FTS TORe groups. At 3 years, patients from both groups regained all the weight lost at 12 months, and the GJ diameter was similar to the pre-procedure assessment. As to QOL, most improvements seen at 12 months were lost at 3 years, returning to pre-procedure levels. Only the energy/fatigue domain improvement was kept between the 1- and 3-year visits.Conclusions Obesity is a chronic relapsing disease. Most effects of TORe are lost at 3 years, and redilation of the GJA occurs. Therefore, TORe should be considered iterative rather than a one-off procedure.
- Management of a refractory marginal ulcer following Roux-en-Y gastric bypass with EUS-guided Roux-en-Y gastric bypass reversal(2023) KERBAGE, A.; ANNAN, K. Al; BRUNALDI, V. O.; RAZZAK, F. A.; ABBOUD, D. M.; GALA, K.; GHANEM, O.; DAYYEH, B. K. Abu
conferenceObject PURE CUT OR ENDOCUT FOR BILIARY SPHINCTEROTOMY? A MULTICENTER RANDOMIZED CLINICAL TRIAL(2023) FUNARI, Mateus; BRUNALDI, Vitor; PROENCA, Igor; OLIVEIRA, Pedro Victor Aniz Gomes De; QUEIROZ, Lucas; VIEIRA, Yuri; MATUGUMA, Sergio; IDE, Edson; FRANZINI, Tomazo; SANTOS, Marcos Eduardo Lera Dos; CHENG, Spencer; MINATA, Mauricio; SANTOS, Jose Sebastiao Dos; MOURA, Diogo De; KEMP, Rafael; MOURA, Eduardo DeconferenceObject ENDOSCOPIC SLEEVE GASTROPLASTY: OVERALL RESULTS AND COMPARISON WITH LAPAROSCOPIC SLEEVE GASTRECTOMY AND LIFESTYLE INTERVENTIONS(2023) BRUNALDI, Vitor; JAGTAP, Nitin; KALAPALA, Rakesh; GALA, Khushboo; KERBAGE, Anthony; MRAD, Rudy; ANNAN, Karim Al; RAZZAK, Farah Abdul; ABBOUD, Donna Maria; STORM, Andrew; VARGAS, Eric; DUVVUR, Nageshwar; DAYYEH, Barham Abu- Tubularization of the gastric pouch helps sustain weight loss after transoral outlet reduction for post- Roux- en-Y gastric bypass weight recurrence(2023) ABBOUD, Donna Maria; GHAZI, Rabih; BRUNALDI, Vitor; GALA, Khushboo; BAROUD, Serge; KERBAGE, Anthony; ABDULRAZZAK, Farah; ANNAN, Karim Al; RAPAKA, Babusai; YAO, Rebecca; VARGAS, Eric J.; STORM, Andrew C.; DAYYEH, Barham K. AbuBackground and study aims Traditional transoral outlet reduction (TORe) is a minimally invasive endoscopic approach focused on reducing the aperture of the gastrojejunal (GJ) anastomosis, while the tubular transoral outlet reduction (tTORe) consists of tabularization of the distal pouch utilizing an O-shape gastroplasty suturing pattern. The primary aim of this study was to compare short- term weight loss between TORe and tTORe. Patients and methods Retrospective analysis of a prospectively maintained database was conducted at a tertiary care bariatric center of excellence. The study included patients with history of Roux- en-Y gastric bypass (RYGB) who had an endoscopic revision by TORe or tTORe and had follow-up data in their electronic medical record. The primary outcome was percent total body weight loss (%TBWL). Results A total of 128 patients were included (tTORe = 85, TORe = 43). At 3 and 6 months, the tTORe and TORe cohorts presented similar % TBWL (3 months: 8.5 +/- 4.9 vs. 7.3 +/- 6.0, P= 0.27 and 6 months: 8.1 +/- 7.4 vs. 6.8 +/- 5.6, P = 0.44). At 9 months, there was a trend toward greater weight loss in the tTORe cohort ( 9.7 +/- 8.6% vs. 5.1 +/- 6.8%, P = 0.053). At 12 months, the %TBWL was significantly higher in the tubularization group compared to the standard group (8.2 +/- 10.8 vs. 2.3 +/- 7.3%, P = 0.01). Procedure time was significantly different between both groups (60.5 vs. 53.4 minutes, P = 0.03). The adverse events rate was similar between groups (8.2% vs. 7.0% for tTORe and TORe, respectively, P = 0.61). Conclusions The tTORe enhances efficacy and durability of the standard procedure without adding significant procedure-related risks.
- Endoscopic ultrasound-guided biliary drainage: a literature review(2023) DA-SILVA, RODRIGO RODA RODRIGUES; MAFRA, LUCAS GALLO DE ALVARENGA; BRUNALDI, VITOR OTTOBONI; ALMEIDA, LETÍCIA FRANÇA DE; ARTIFON, EVERSON LUIZ DE ALMEIDAABSTRACT Neoplasms of the biliopancreatic confluence may present with obstruction of the bile tract, leading to jaundice, pruritus and cholangitis. In these cases drainage of the bile tract is imperative. Endoscopic retrograde cholangiopancreatography (ERCP) with placement of a choledochal prosthesis is an effective treatment in about 90% of cases, even in experienced hands. In cases of ERCP failure, therapeutic options traditionally include surgical bypass by hepaticojejunostomy (HJ) or percutaneous transparietohepatic drainage (DPTH). In recent years, endoscopic ultrasound-guided biliary drainage techniques have gained space because they are less invasive, effective and have an acceptable incidence of complications. Endoscopic echo-guided drainage of the bile duct can be performed through the stomach (hepatogastrostomy), duodenum (choledochoduodenostomy) or by the anterograde drainage technique. Some services consider ultrasound-guided drainage of the bile duct the procedure of choice in the event of ERCP failure. The objective of this review is to present the main types of endoscopic ultrasound-guided biliary drainage and compare them with other techniques.
conferenceObject PURE CUT OR ENDOCUT FOR BILIARY SPHINCTEROTOMY? A MULTICENTER RANDOMIZED CLINICAL TRIAL(2023) FUNARI, Mateus; BRUNALDI, Vitor; PROENCA, Igor; OLIVEIRA, Pedro Victor Aniz Gomes De; QUEIROZ, Lucas; VIEIRA, Yuri; MATUGUMA, Sergio; IDE, Edson; FRANZINI, Tomazo; SANTOS, Marcos Eduardo Lera Dos; CHENG, Spencer; MINATA, Mauricio; SANTOS, Jose Sebastiao Dos; MOURA, Diogo De; KEMP, Rafael; MOURA, Eduardo De- Palliative therapy for malignant gastric outlet obstruction: how does the endoscopic ultrasound-guided gastroenterostomy compare with surgery and endoscopic stenting? A systematic review and meta-analysis(2023) MARTINS, Rafael Krieger; BRUNALDI, Vitor Ottoboni; FERNANDES, Andre Luis; OTOCH, Jose Pinhata; ARTIFON, Everson Luiz de AlmeidaIntroduction:The gold-standard procedure to address malignant gastric outlet obstruction (MGOO) is surgical gastrojejunostomy (SGJJ). Two endoscopic alternatives have also been proposed: the endoscopic stenting (ES) and the endoscopic ultrasound-guided gastroenterostomy (EUS-G). This study aimed to perform a thorough and strict meta-analysis to compare EUS-G with the SGJJ and ES in treating patients with MGOO. Materials and Methods:Studies comparing EUS-G to endoscopic stenting or SGJJ for patients with MGOO were considered eligible. We conducted online searches in primary databases (MEDLINE, EMBASE, Lilacs, and Central Cochrane) from inception through October 2021. The outcomes were technical and clinical success rates, serious adverse events (SAEs), reintervention due to obstruction, length of hospital stay (LOS), and time to oral intake. Results:We found similar technical success rates between ES and EUS-G but clinical success rates favored the latter. The comparison between EUS-G and SGJJ demonstrated better technical success rates in favor of the surgical approach but similar clinical success rates. EUS-G shortens the LOS by 2.8 days compared with ES and 5.8 days compared with SGJJ. Concerning reintervention due to obstruction, we found similar rates for EUS-G and SGJJ but considerably higher rates for ES compared with EUS-G. As to AEs, we demonstrated equivalent rates comparing EUS-G and SGJJ but significantly higher ones compared with ES. Conclusion:Despite being novel and still under refinement, the EUS-G has good safety and efficacy profiles compared with SGJJ and ES.
- Endoscopic resection of a gastric GI stromal tumor using the helix-snaring technique(2023) QUADROS, L. G. de; BRUNALDI, V. O.; SILVA, M. C.; GALVAO NETO, M.; GALA, K.; DAYYEH, B. Abu
- Improvements in hepatic steatosis, obesity, and insulin resistance in adults with nonalcoholic fatty liver disease after the primary obesity surgery endoluminal 2.0 procedure(2023) ALKHATRY, Maryam; RAPAKA, Babusai; MASELLI, Daniel B.; ABBOUD, Donna Maria; BRUNALDI, Vitor O.; MAHMOUD, Tala; GHAZI, Rabih; RAZZAK, Farah Abdul; GALA, Khushboo; JOUDAH, Imad; HOUSEN, Fedaa; QADI, Sana Al; VARGAS, Eric J.; STORM, Andrew C.; DAYYEH, Barham K. AbuBackground The primary obesity surgery endoluminal 2.0 (POSE 2.0) procedure involves full-thickness gastric body plications to narrow the stomach using durable suture anchor pairs. We evaluated POSE 2.0 as a treatment strategy for nonalcoholic fatty liver disease (NAFLD) in patients with obesity. Methods Adults with obesity and NAFLD were prospectively allocated based on their preference to undergo POSE 2.0 with lifestyle modification or lifestyle modification alone (control). Primary end points were improvement in controlled attenuation parameter (CAP) and resolution of hepatic steatosis at 12 months. Secondary end points included %total body weight loss (%TBWL), change in serum measures of hepatic steatosis and insulin resistance, and procedure safety. Results 42 adult patients were included (20 in the POSE 2.0 arm and 22 in the control arm). At 12 months, POSE 2.0 significantly improved CAP, whereas lifestyle modification alone did not (P < 0.001 for POSE 2.0; P = 0.24 for control). Similarly, both resolution of steatosis and %TBWL were significantly higher with POSE 2.0 than with control at 12 months. Compared with controls, POSE 2.0 significantly improved liver enzymes, hepatic steatosis index, and aspartate aminotransferase to platelet ratio at 12 months. There were no serious adverse events. Conclusion POSE 2.0 was effective for NAFLD in patients with obesity, with good durability and safety profile.