TOMAZO ANTONIO PRINCE FRANZINI

(Fonte: Lattes)
Índice h a partir de 2011
8
Lattes
ResearcherID
ORCID
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

Filtros

Limpar filtros

Configurações

Indexador: PubMed ×

Resultados de Busca

Agora exibindo 1 - 10 de 18
  • article 1 Citação(ões) na Scopus
    Pure Cut or Endocut for Biliary Sphincterotomy? A Multicenter Randomized Clinical Trial
    (2023) FUNARI, Mateus Pereira; BRUNALDI, Vitor Ottoboni; PROENCA, Igor Mendonca; GOMES, Pedro Victor Aniz; QUEIROZ, Lucas Tobias Almeida; VIEIRA, Yuri Zamban; MATUGUMA, Sergio Eiji; IDE, Edson; FRANZINI, Tomazo Antonio Prince; SANTOS, Marcos Eduardo Lera dos; CHENG, Spencer; MINATA, Mauricio Kazuyoshi; SANTOS, Jose Sebastio dos; MOURA, Diogo Turiani Hourneaux de; KEMP, Rafael; MOURA, Eduardo Guimares Hourneaux de
    INTRODUCTION: Adverse events (AE) after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and post-ERCP acute pancreatitis (PEP) is the most important one. Thermal injury from biliary sphincterotomy may play an important role and trigger PEP or bleeding. Therefore, this study evaluated the outcomes of 2 electric current modes used during biliary sphincterotomy. METHODS: From October 2019 to August 2021, consecutive patients with native papilla undergoing ERCP with biliary sphincterotomy were randomized to either the pure cut or endocut after cannulation. The primary outcome was PEP incidence. Secondary outcomes included intraprocedural and delayed bleeding, infection, and perforation. RESULTS: A total of 550 patients were randomized (272 pure cut and 278 endocut). The overall PEP rate was 4.0% and significantly higher in the endocut group (5.8% vs 2.2%, P = 0.034). Univariate analysis revealed >5 attempts (P = 0.004) and endocut mode (P = 0.034) as risk factors for PEP. Multivariate analysis revealed >5 attempts (P = 0.005) and a trend for endocut mode as risk factors for PEP (P = 0.052). Intraprocedural bleeding occurred more often with pure cut (P = 0.018), but all cases were controlled endoscopically during the ERCP. Delayed bleeding was more frequent with endocut (P = 0.047). There was no difference in perforation (P = 1.0) or infection (P = 0.4999) between the groups. DISCUSSION: Endocut mode may increase thermal injury leading to higher rates of PEP and delayed bleeding, whereas pure cut is associated with increased intraprocedural bleeding without clinical repercussion. The electric current mode is not related to perforation or infection. Further RCT assessing the impact of electric current on AE with overlapping preventive measures such as rectal nonsteroidal anti-inflammatory drugs and hyperhydration are needed. The study was submitted to the Brazilian Clinical Trials Platform (http://www.ensaiosclinicos.gov.br) under the registry number RBR-5d27tn.
  • article
    Nonsteroidal anti-inflammatory drugs versus placebo for post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis
    (2019) SERRANO, Juan Pablo Roman; MOURA, Diogoturiani Hourneaux de; BERNARDO, Wanderley Marques; RIBEIRO, Igor Braga; FRANZINI, Tomazo Prince; MOURA, Eduardo Turiani Hourneaux de; BRUNALDI, Vitor Ottoboni; SALESSE, Marianne Torrezan; SAKAI, Paulo; MOURA, Eduardo Guimaraes Hourneaux De
    Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is the primary therapeutic procedure for treatment of diseases that affect the biliary tree and pancreatic duct. While the therapeutic success rate of ERCP is high, the procedure can cause complications, such as acute pancreatitis (PEP), bleeding, and perforation. This meta-analysis aimed to assess the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing PEP following (ERCP). Materials and methods We searched databases, such as MEDLINE, Embase, and Cochrane Central Library. Only randomized controlled trials (RCTs) that compared the efficacy of NSAIDs and placebo for the prevention of PEP were included. Outcomes assessed included incidence of PEP, severity of pancreatitis, route of administration, and type of NSAIDs. Results Twenty-one RCTs were considered eligible with a total of 6854 patients analyzed. Overall, 3427 patients used NSAIDs before ERCP and 3427 did not use the drugs (control group). In the end, 250 cases of acute pancreatitis post-ERCP were diagnosed in the NSAIDs group and 407 cases in the placebo group. Risk for PEP was lower in the NSAID group (risk difference (RD): -0.05; 95% confidence interval (CI): -0.07 to -0.03; number need to treat (NNT), 20; P<0.05). Use of NSAIDs effectively prevented mild pancreatitis compared with use of placebo (2.5% vs. 4.1%; 95% CI, -0.05 to -0.01; NNT, 33; P<0.05), but the information on moderate and severe PEP could not be completely elucidated. Only rectal administration reduced incidence of PEP (6.8% vs. 13 %; 95% CI, -0.10 to -0.04; NNT, 20; P<0.05). Furthermore, only diclofenac or indomethacin use was effective in preventing PEP. Conclusions Rectal administration of diclofenac and indomethacin significantly reduced risk of developing mild PEP. Further RCTs are needed to compare efficacy between NSAID administration pathways in prevention of PEP after ERCP.
  • 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
  • article 3 Citação(ões) na Scopus
    Common bile duct intussusception during ERCP for stone removal
    (2018) ROCHA, R. S. D. P.; MINATA, M. K.; MOURA, D. T. H. de; MOURA, E. G. H. de; FRANZINI, T. A. P.
    [No abstract available]
  • conferenceObject
    PER ORAL CHOLANGIOSCOPY (POCS) IN LIVER TRANSPLANT PATIENTS: A PROSPECTIVE, INTERNATIONAL SERIES
    (2022) FRANZINI, Tomazo; MOURA, Eduardo G. De; CARDENAS, Andres; SLIVKA, Adam; WERNER-POLEY, Jan; PAPACHRISTOU, Georgios; RABINOVITZ, Mordechai; BRUNO, Marco J.; PEETERMANS, Joyce A.; ROUSSEAU, Matthew; YIN, Srey; ANDRAUS, Wellington; EMOND, Jean; SETHI, Amrita
  • article 3 Citação(ões) na Scopus
    Cholangioscopy in a post-Covid-19 cholangiopathy patient
    (2022) FRANZINI, T. A. P.; GUEDES, M. M. F.; ROCHA, H. L. O. G.; FLEURY, C. A.; BESTETTI, A. M.; MOURA, E. G. H. de
  • article
    Biliary drainage in inoperable malignant biliary distal obstruction: A systematic review and meta-analysis
    (2021) SCATIMBURGO, Maria Vitoria Cury Vieira; RIBEIRO, Igor Braga; MOURA, Diogo Turiani Hourneaux de; SAGAE, Vitor Massaro Takamatsu; HIRSCH, Bruno Salomao; BOGHOSSIAN, Mateus Bond; MCCARTY, Thomas R.; SANTOS, Marcos Eduardo Lera dos; FRANZINI, Tomazo Antonio Prince; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux de
    Y BACKGROUND Endoscopic drainage remains the treatment of choice for unresectable or inoperable malignant distal biliary obstruction (MDBO). AIM To compare the safety and efficacy of plastic stent (PS) vs self-expanding metal stent (SEMS) placement for treatment of MDBO. METHODS This meta-analysis was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search was performed in MEDLINE, Cochrane, Embase, Latin American and Caribbean Health Sciences Literature, and grey literature to identify randomized clinical trials (RCTs) comparing clinical success, adverse events, stent dysfunction rate, reintervention rate, duration of stent patency, and mean survival. Risk difference (RD) and mean difference (MD) were calculated and heterogeneity was assessed with I-2 statistic. Subgroup analyses were performed by SEMS type. RESULTS Twelve RCTs were included in this study, totaling 1005 patients. There was no difference in clinical success (RD = -0.03, 95% confidence interval [CI]: -0.01, 0.07; I-2 = 0%), rate of adverse events (RD = -0.03, 95%CI: -0.10, 0.03; I-2 = 57%), and mean patient survival (MD = -0.63, 95%CI: -18.07, 19.33; I-2 = 54%) between SEMS vs PS placement. However, SEMS placement was associated with a lower rate of reintervention (RD = -0.34, 95%CI: -0.46, -0.22; I-2 = 57%) and longer duration of stent patency (MD = 125.77 d, 95%CI: 77.5, 174.01). Subgroup analyses revealed both covered and uncovered SEMS improved stent patency compared to PS (RD = 152.25, 95%CI: 37.42, 267.07; I-2 = 98% and RD = 101.5, 95%CI: 38.91, 164.09; I-2 = 98%; respectively). Stent dysfunction was higher in the covered SEMS group (RD = -0.21, 95%CI: -0.32, -0.1; I-2 = 205%), with no difference in the uncovered SEMS group (RD = -0.08, 95%CI: -0.56, 0.39; I-2 = 87%). CONCLUSION While both stent types possessed a similar clinical success rate, complication rate, and patient-associated mean survival for treatment of MDBO, SEMS were associated with a longer duration of stent patency compared to PS.
  • article
    Impact of coronavirus pandemic crisis in endoscopic clinical practice: Results from a national survey in Brazil
    (2020) ARANTES, Vitor Nunes; MARTINS, Bruno Costa; SEQATTO, Raphael; MILHOMEN-CARDOSO, Daniela Medeiros; FRANZINI, Tomazo Prince; ZUCCARO, Anna Maria; ALVES, Jairo Silva; MALUF-FILHO, Fauze
    Background and study aims In March 2020, the World Health Organization declared coronavirus disease of 2019 (COVID-19) as a pandemic, mobilizing all countries to contain the disease spread. Activity in endoscopy centers globally was severely affected. We conducted a national survey aiming to assess the impact of the COVID-19 outbreak on endoscopic clinical practice in Brazil. Methods In April 2020, 3,719 associate members of SOBED (Brazilian Society of Digestive Endoscopy) were invited to respond to an electronic survey. An Internet link was established to provide access to the online questionnaire with 40 questions regarding personal profile, endoscopy unit logistics and schedule, availability and use of personal protective equipment (PPE), financial impact, and exposure to COVID-19. Results A total of 2,131 individuals (67 %) accessed the questionnaire and 1155 responses were received. After review, 980 responses were considered valid. According to almost 90 % of respondents, endoscopy activity was restricted to urgent procedures, in both public and private hospitals. All respondents increased PPE use after the outbreak, however, institutions provided adequate PPE to only 278 responders (28.7 %). Significant income loss was universally reported. A total of 10 practitioners (1 %) reported COVID-19 infection and attributed the contamination to endoscopic procedures. Conclusions Based on this nationwide survey with almost 1,000 respondents, the COVID-19 pandemic substantially reduced the activity of endoscopy units in private and public settings. The pandemic increased awareness of PPE use, but its availability was not universal and 1 % of the respondents became infected with COVID-19, allegedly due to exposure during endoscopic procedures.
  • 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
  • article
    Comparison between endoscopic sphincterotomy vs endoscopic sphincterotomy associated with balloon dilation for removal of bile duct stones: A systematic review and meta-analysis based on randomized controlled trials
    (2018) CLEMENTE JUNIOR, Cesar Capel de; BERNARDO, Wanderley Marques; FRANZINI, Tomazo Prince; LUZ, Gustavo Oliveira; SANTOS, Marcos Eduardo Lera dos; COHEN, Jonah Maxwell; MOURA, Diogo Turiani Hourneaux de; MARINHO, Fabio Ramalho Tavares; CORONEL, Martin; SAKAI, Paulo; MOURA, Eduardo Guimaraes Hourneaux de
    AIM To compare gallstones removal rate and incidence of bleeding, pancreatitis, use of mechanical lithotripsy, cholangitis and perforation between isolated sphincterotomy vs sphincterotomy associated with balloon dilation of papilla in choledocholithiasis through the meta-analysis of randomized clinical trials. METHODS We conducted a systematic review according to the PRISMA guidelines. Literature search was restricted to randomized controlled trials (RCTs) on MedLine, Cochrane Library, LILACS, and EMBASE database platforms in July 2017. The manual search included references of retrieved articles. We extracted data focusing on outcomes: The primary endpoint was the stones removal rate; Secondary endpoints were rates of pancreatitis, bleeding, use of mechanical lithotripsy (ML), perforation and cholangitis. RESULTS Eleven RCTs with 1824 patients were included. EST was associated with more post-endoscopic retrograde cholangiopancreatography (ERCP) bleeding [FE RD-0.02, CI (-0.03, -0.00), I-2 = 33%, P = 0.05] and more need of mechanical lithotripsy in general [RE RD-0.16, CI (-0.25, -0.06), I-2 = 90%, P = 0.002] and in subgroup analysis of stones greater than 15 mm [RE RD-0.20, CI (-0.38, -0.02), I-2 = 82%, P = 0.003]. Incidence of pancreatitis [FE RD-0.01, CI (-0.03, 0.01), I-2 = 0, P = 0.36], cholangitis [FE RD-0.00, CI (-0.01, 0.01), I-2 = 0, P = 0.97] and perforation [FE RD-0.01, CI (-0.01, 0.00), I-2 = 0, P = 0.23] was similar between the groups as well as similar stone removal rates in general [FE RD-0.01, CI (-0.01, 0.04), I-2 = 0, P = 0.23] and pooled analysis of stones greater than 15 mm [FE RD-0.02, CI (-0.02, 0.07), I-2 = 11%, P = 0.31]. CONCLUSION Through meta-analysis of randomized clinical trials we found that isolated sphincterotomy was associated with more post-ERCP bleeding and more need for mechanical lithotripsy. However, there was no statistical difference in the stone removal rate between isolated sphincterotomy and sphincterotomy associated with balloon dilation in the approach to remove gallstones.