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
51 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 51
- Comparison between Enteroscopy-Based and Laparoscopy-Assisted ERCP for Accessing the Biliary Tree in Patients with Roux-en-Y Gastric Bypass: Systematic Review and Meta-analysis(2018) PONTE-NETO, Alberto Machado da; BERNARDO, Wanderley M.; COUTINHO, Lara M. de A.; JOSINO, Iatagan Rocha; BRUNALDI, Vitor Ottoboni; MOURA, Diogo T. H.; SAKAI, Paulo; KUGA, Rogerio; MOURA, Eduardo G. H. deAlthough balloon-assisted enteroscopy-endoscopic retrograde cholangiopancreatography (BAE-ERCP) is a well-described means of accessing the duodenal papilla in patients with Roux-en-Y gastric bypass (RYGB), it is associated with modest clinical success rates. Laparoscopy-assisted ERCP (LA-ERCP)performed by advancing a standard duodenoscope through a gastrostomy into the excluded stomach and duodenumhas emerged as a viable alternative to BAE-ERCP, with apparently higher success rates. In this systematic review, we compare LA-ERCP with enteroscopy-based techniques in post-RYGB patients, including 22 case series that provided data on papilla identification, papilla cannulation, and complications. We found that LA-ERCP was superior to the enteroscopy-based techniques in its capacity to reach the duodenal papilla, although complication rates were lower for the latter. Comparative studies are needed in order to corroborate our findings.
- In Brief(2020) TATARIAN, Talar; RONA, Kais A.; SHIN, Daniel H.; CHEN, Daniel G.; DUCOIN, Christopher G.; MOORE, Rachel L.; BRUNALDI, Vitor O.; GALVAO-NETO, Manoel; ARDILA-GATAS, Jessica; DOCIMO, Salvatore; MOURA, Diogo T. Hourneax de; JIRAPINYO, Pichamol; THOMPSON, Christopher C.; BILLY, Helmuth T.; ROSLIN, Mitchell S.; BORDEN, Billie; ZARABI, Sharon; SWEIGERT, Patrick J.; CHAND, Bipan; PRYOR, Aurora D.
- Suction versus slow-pull for endoscopic ultrasound-guided fine-needle aspiration of pancreatic tumors: a prospective randomized trial(2020) CHENG, Spencer; BRUNALDI, Vitor O.; MINATA, Mauricio K.; CHACON, Danielle A.; SILVEIRA, Eduardo B.; MOURA, Diogo T. H. de; SANTOS, Marcos E. L. Dos; MATUGUMA, Sergio E.; CHAVES, Dalton M.; FRANCA, Raony F.; JACOMO, Alfredo L.; ARTIFON, Everson L. A.Background: Suction (S) is commonly used to improve cell acquisition during endoscopic ultrasoundguided fine-needle aspiration (EUS-FNA). Slow-pull (SP) sampling is another technique that might procure good quality specimens with less bloodiness. We aimed to determine if SP improves the diagnostic yield of EUS-FNA of pancreatic masses. Methods: Patients with pancreatic solid masses were randomized to four needle passes with both techniques in an alternate fashion. Sensitivity, specificity, positive, and negative predictive values were calculated. Cellularity and bloodiness of cytological samples were assessed and compared according to the technique. Results: Sensitivity, specificity, and accuracy of suction vs. SP were 95.2% vs. 92.3%; 100% vs. 100; 95.7% vs. 93%, respectively. As to the association of methods, they were 95.6, 100 and 96%, respectively. Positive predictive values for S and SP were 100%. There was no difference in diagnostic yield between S and SP (p = 0.344). Cellularity of samples obtained with SP and Suction were equivalent in both smear evaluation (p = 0.119) and cell-block (0.980). Bloodiness of SP and suction techniques were similar as well. Conclusions: S and SP techniques provide equivalent sensitivity, specificity, and accuracy. Association of methods seems to improve diagnostic yield. Suction does not increase the bloodiness of samples compared to slow-pull.
- COMPARATION BETWEEN DIFFERENT METHODS OF SURVEILLANCE OF DYSPLASTIC LESIONS IN PATIENTS WIHT ULCERATIVE COLITIS AND CROHN'S DISEASE: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS(2019) RESENDE, Ricardo H.; BERNARDO, Wanderlei M.; MARCO, Michele O. De; REZENDE, Daniel T.; MOTA, Raquel Cristina L.; BRUNALDI, Vitor O.; FURUYA, Carlos K.; ISHIDA, Robson K.; KUGA, Rogerio; MOURA, Eduardo G. de
conferenceObject Hemostatic Powder: A New Ally for the Management of Post-Sphincterotomy Bleeding(2017) BARACAT, Felipe I.; BRUNALDI, Vitor O.; MOURA, Diogo T. de; MATUGUMA, Sergio E.; BARACAT, Renato; MOURA, Eduardo G. de- Is Endoscopic Balloon Dilation Still Associated With Higher Rates of Pancreatitis? A Systematic Review and Meta-Analysis(2020) MATSUBAYASHI, Carolina Ogawa; RIBEIRO, Igor Braga; MOURA, Diogo Turiani Hourneaux de; BRUNALDI, Vitor Ottoboni; BERNARDO, Wanderley Marques; HATHORN, Kelly E.; MOURA, Eduardo Guimaraes Hourneaux deThe objective of this study was to compare the efficacy and safety of endoscopic papillary balloon dilation (EPBD), endoscopic sphincterotomy (ES), and the combination of large balloon dilation and ES (ES + EPLBD) in the treatment of common bile duct stones, with a special focus on postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Individualized search strategies were developed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included randomized controlled trials (RCTs) which evaluated at least one of the following outcomes: PEP, complete stone removal in the first ERCP, need for mechanical lithotripsy, recurrence of common bile duct stones, bleeding, and cholangitis. Twenty-five RCTs were selected for analysis. Pancreatitis rates were higher for EPBD than for ES (P = 0.003), as were severe pancreatitis rates (P = 0.04). However, in the 10-mm or greater balloon subgroup analysis, this difference was not shown (P = 0.82). Rates of PEP were higher in the subgroup of non-Asian subjects (P = 0.02), and the results were not robust when RCTs that used endoscopic nasobiliary drainage were omitted. The incidence of pancreatitis was comparable between EPLBD and ES + EPLBD. All 3 approaches were equally efficacious. Nevertheless, the results should be interpreted with caution, because pancreatitis is a multifactorial pathology, and RCTs can have limited generalizability.
- Endoscopic Treatment of Weight Regain Following Roux-en-Y Gastric Bypass: a Systematic Review and Meta-analysis(2018) BRUNALDI, Vitor Ottoboni; JIRAPINYO, Pichamol; MOURA, Diogo Turiani H. de; OKAZAKI, Ossamu; BERNARDO, Wanderley M.; GALVO NETO, Manoel; CAMPOS, Josemberg Marins; SANTO, Marco Aurelio; MOURA, Eduardo G. H. deRoux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric procedure. Despite its high efficacy, some patients regain part of their lost weight. Several endoscopic therapies have been introduced as alternatives to treat weight regain, but most of the articles are relatively small with unclear long-term data. To systematically assess the efficacy of endoscopic therapies for weight regain after RYGB. We searched MEDLINE, EMBASE, Scopus, Web of Science, Cochrane, OVID, CINAHL/EBSCo, LILACS/Bireme, and gray literature. Primary outcomes were absolute weight loss (AWL), excess weight loss (EWL), and total body weight loss (TBWL). Thirty-two studies were included in qualitative analysis. Twenty-six described full-thickness (FT) endoscopic suturing and pooled AWL, EWL, and TBWL at 3 months were 8.5 +/- 2.9 kg, 21.6 +/- 9.3%, and 7.3 +/- 2.6%, respectively. At 6 months, they were 8.6 +/- 3.5 kg, 23.7 +/- 12.3%, and 8.0 +/- 3.9%, respectively. At 12 months, they were 7.63 +/- 4.3 kg, 16.9 +/- 11.1%, and 6.6 +/- 5.0%, respectively. Subgroup analysis showed that all outcomes were significantly higher in the group with FT suturing combined with argon plasma coagulation (APC) (p < 0.0001). Meta-analysis included 15 FT studies and showed greater results. Three studies described superficial-thickness suturing with pooled AWL of 3.0 +/- 3.8, 4.4 +/- 0.07, and 3.7 +/- 7.4 kg at 3, 6, and 12 months, respectively. Two articles described APC alone with mean AWL of 15.4 +/- 2.0 and 15.4 +/- 9.1 kg at 3 and 6 months, respectively. Full-thickness suturing is effective at treating weight regain after RYGB. Performing APC prior to suturing seems to result in greater weight loss. Head-to-head studies are needed to confirm our results. Few studies adequately assess effectiveness of other endoscopic techniques.
- PREDICTORS OF GASTROESOPHAGEAL REFLUX AFTER POEM FOR ACHALASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS(2019) MOTA, Raquel Cristina L.; MOURA, Eduardo G. de; MOURA, Diogo T. de; MOURA, Eduardo T.; FARIAS, Galileu F.; BRUNALDI, Vitor O.; BERNARDO, Wanderlei M.; SAKAI, Paulo; THOMPSON, Christopher C.
- Obesity Treatment with Botulinum Toxin-A Is Not Effective: a Systematic Review and Meta-Analysis(2017) BUSTAMANTE, Fabio; BRUNALDI, Vitor Ottoboni; BERNARDO, Wanderley Marques; MOURA, Diogo Turiani H. de; MOURA, Eduardo Turiani H. de; GALVAO, Manoel; SANTO, Marco Aurelio; MOURA, Eduardo Guimares H. deThe effectiveness of gastric injections of botulinum toxin-A (BTA) as primary treatment for obesity is not well known since results in literature are discrepant. Hence, we aimed to systematically review and meta-analyze the available data to assess the real effect of BTA therapy. We searched MEDLINE, Embase, Cochrane, SCOPUS, EBSCO, LILACS, and BVS. We considered eligible only randomized controlled trials enrolling obese patients comparing BTA versus saline injections. Our initial search identified 8811 records. Six studies fulfilled eligibility criteria. After critical appraisal, two articles were excluded and we meta-analyzed the remainder. The mean difference for absolute weight loss and BMI reduction were 0.12 [CI 95%, - 1.14, 1.38] and - 0.06 [95% CI, - 0.92, 0.81], respectively. Therefore, we concluded that treatment of obesity with BTA is not effective.
- Response to ""The Forgotten Fundus-Obesity Treatment with Botulinum Toxin-A Is Not Effective: a Systematic Review and Meta-Analysis""(2018) BRUNALDI, Vitor Ottoboni; BUSTAMANTE, Fabio; BERNARDO, Wanderley M.; MOURA, Eduardo G. H. de