MAURICIO KAZUYOSHI MINATA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
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- Narrow band imaging versus lugol chromoendoscopy to diagnose squamous cell carcinoma of the esophagus: a systematic review and meta-analysis(2017) MORITA, Flavio Hiroshi Ananias; BERNARDO, Wanderley Marques; IDE, Edson; ROCHA, Rodrigo Silva Paula; AQUINO, Julio Cesar Martins; MINATA, Mauricio Kazuyoshi; YAMAZAKI, Kendi; MARQUES, Sergio Barbosa; SAKAI, Paulo; MOURA, Eduardo Guimaraes Hourneaux deBackground: In the early stage esophageal cancer, changes in the mucosa are subtle and pass unnoticed in endoscopic examinations using white light. To increase sensitivity, chromoscopy with Lugol's solution has been used. Technological advancements have led to the emergence of virtual methods of endoscopic chromoscopy, including narrow band imaging (NBI). NBI enhances the relief of the mucosa and the underlying vascular pattern, providing greater convenience without the risks inherent to the use of vital dye. The purpose of this systematic review and meta-analysis was to evaluate the ability of NBI to diagnose squamous cell carcinoma of the esophagus and to compare it to chromoscopy with Lugol's solution. Methods: This systematic review included all studies comparing the diagnostic accuracy of NBI and Lugol chromoendoscopy performed to identify high-grade dysplasia and/or squamous cell carcinoma in the esophagus. In the meta-analysis, we calculated and demonstrated sensitivity, specificity, and positive and negative likelihood values in forest plots. We also determined summary receiver operating characteristic (sROC) curves and estimates of the areas under the curves for both per-patient and per-lesion analysis. Results: The initial search identified 7079 articles. Of these, 18 studies were included in the systematic review and 12 were used in the meta-analysis, for a total of 1911 patients. In per-patient and per-lesion analysis, the sensitivity, specificity, and positive and negative likelihood values for Lugol chromoendoscopy were 92% and 98, 82 and 37%, 5.42 and 1.4, and 0.13 and 0.39, respectively, and for NBI were 88 and 94%, 88 and 65%, 8.32 and 2.62, and 0.16 and 0.12, respectively. There was a statistically significant difference in only specificity values, in which case NBI was superior to Lugol chromoendoscopy in both analyses. In the per-patient analysis, the area under the sROC curve for Lugol chromoendoscopy was 0.9559. In the case of NBI, this value was 0.9611; in the per-lesion analysis, this number was 0.9685 and 0.9587, respectively. Conclusions: NBI was adequate in evaluating the esophagus in order to diagnose high-grade dysplasia and squamous cell carcinoma. In the differentiation of those disorders from other esophageal mucosa alterations, the NBI was shown to be superior than Lugol.
- Sodium picosulphate or polyethylene glycol before elective colonoscopy in outpatients? A systematic review and meta-analysis(2018) ROCHA, Rodrigo Silva de Paula; RIBEIRO, Igor Braga; MOURA, Diogo Turiani Hourneaux de; BERNARDO, Wanderley Marques; MINATA, Mauricio Kazuyoshi; MORITA, Flavio Hiroshi Ananias; AQUINO, Julio Cesar Martins; BABA, Elisa Ryoka; MIYAJIMA, Nelson Tomio; MOURA, Eduardo Guimaraes Hourneaux deAIM To determine the best option for bowel preparation [sodium picosulphate or polyethylene glycol (PEG)] for elective colonoscopy in adult outpatients. METHODS A systematic review of the literature following the PRISMA guidelines was performed using Medline, Scopus, EMBASE, Central, Cinahl and Lilacs. No restrictions were placed for country, year of publication or language. The last search in the literature was performed on November 20th, 2017. Only randomized clinical trials with full texts published were included. The subjects included were adult outpatients who underwent bowel cleansing for elective colonoscopy. The included studies compared sodium picosulphate with magnesium citrate (SPMC) and PEG for bowel preparation. Exclusion criteria were the inclusion of inpatients or groups with specific conditions, failure to mention patient status (outpatient or inpatient) or dietary restrictions, and permission to have unrestricted diet on the day prior to the exam. Primary outcomes were bowel cleaning success and/or tolerability of colon preparation. Secondary outcomes were adverse events, polyp and adenoma detection rates. Data on intention-totreat were extracted by two independent authors and risk of bias assessed through the Jadad scale. Funnel plots, Egger's test, Higgins' test (I2) and sensitivity analyses were used to assess reporting bias and heterogeneity. The meta-analysis was performed by computing risk difference (RD) using Mantel-Haenszel (MH) method with fixed-effects (FE) and random-effects (RE) models. Review Manager 5 (RevMan 5) version 6.1 (The Cochrane Collaboration) was the software chosen to perform the meta-analysis. RESULTS 662 records were identified but only 16 trials with 6200 subjects were included for the meta-analysis. High heterogeneity among studies was found and sensitivity analysis was needed and performed to interpret data. In the pooled analysis, SPMC was better for bowel cleaning [MH FE, RD 0.03, IC (0.01, 0.05), P = 0.003, I-2 = 33%, NNT 34], for tolerability [MH RE, RD 0.08, IC (0.03, 0.13), P = 0.002, I-2 = 88%, NNT 13] and for adverse events [MH RE, RD 0.13, IC (0.05, 0.22), P = 0.002, I-2 = 88%, NNT 7]. There was no difference in regard to polyp and adenoma detection rates. Additional analyses were made by subgroups (type of regimen, volume of PEG solution and dietary recommendations). SPMC demonstrated better tolerability levels when compared to PEG in the following subgroups: ""day-before preparation"" [MH FE, RD 0.17, IC (0.13, 0.21), P < 0.0001, I-2 = 0%, NNT 6], "" preparation in accordance with time interval for colonoscopy"" [MH RE, RD 0.08, IC (0.01, 0.15), P = 0.02, I-2 = 54%, NNT 13], when compared to ""high-volume PEG solutions"" [MH RE, RD 0.08, IC (0.01, 0.14), I-2 = 89%, P = 0.02, NNT 13] and in the subgroup "" liquid diet on day before"" [MH RE, RD 0.14, IC (0.06,0.22), P = 0.0006, I-2 = 81%, NNT 8]. SPMC was also found to cause fewer adverse events than PEG in the "" high-volume PEG solutions"" [MH RE, RD -0.18, IC (-0.30, -0.07), P = 0.002, I-2 = 79%, NNT 6] and PEG in the "" low-residue diet"" subgroup [MH RE, RD -0.17, IC (-0.27, 0.07), P = 0.0008, I-2 = 86%, NNT 6]. CONCLUSION SPMC seems to be better than PEG for bowel preparation, with a similar bowel cleaning success rate, better tolerability and lower prevalence of adverse events.
- EBUS-TBNA versus surgical mediastinoscopy for mediastinal lymph node staging in potentially operable non-small cell lung cancer: a systematic review and meta-analysis(2020) FIGUEIREDO, Viviane Rossi; CARDOSO, Paulo Francisco Guerreiro; JACOMELLI, Marcia; SANTOS, Lilia Maia; MINATA, Mauricio; TERRA, Ricardo MingariniABSTRACT Objective: Lung cancer (LC) is one of the leading causes of death worldwide. Accurate mediastinal staging is mandatory in order to assess prognosis and to select patients for surgical treatment. EBUS-TBNA is a minimally invasive procedure that allows sampling of mediastinal lymph nodes (LNs). Some studies have suggested that EBUS-TBNA is preferable to surgical mediastinoscopy for mediastinal staging of LC. The objective of this systematic review and meta-analysis was to compare EBUS-TBNA and mediastinoscopy in terms of their effectiveness for mediastinal LN staging in potentially operable non-small cell lung cancer (NSCLC). Methods: This was a systematic review and meta-analysis, in which we searched various databases. We included studies comparing the accuracy of EBUS-TBNA with that of mediastinoscopy for mediastinal LN staging in patients with NSCLC. In the meta-analysis, we calculated sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios. We also analyzed the risk difference for the reported complications associated with each procedure. Results: The search identified 4,201 articles, 5 of which (with a combined total of 532 patients) were selected for inclusion in the meta-analysis. There were no statistically significant differences between EBUS-TBNA and mediastinoscopy in terms of the sensitivity (81% vs. 75%), specificity (100% for both), positive likelihood ratio (101.03 vs. 95.70), or negative likelihood ratio (0.21 vs. 0.23). The area under the summary ROC curve was 0.9881 and 0.9895 for EBUS-TBNA and mediastinoscopy, respectively. Although the number of complications was higher for mediastinoscopy, the difference was not significant (risk difference: −0.03; 95% CI: −0.07 to 0.01; I2 = 76%). Conclusions: EBUS-TBNA and mediastinoscopy produced similar results for mediastinal staging of NSCLC. EBUS-TBNA can be the procedure of first choice for LN staging in patients with NSCLC.
- Efficacy and Safety of Stents in the Treatment of Fistula After Bariatric Surgery: a Systematic Review and Meta-analysis(2018) OKAZAKI, Ossamu; BERNARDO, Wanderley M.; BRUNALDI, Vitor O.; CLEMENTE JUNIOR, Cesar C. de; MINATA, Mauricio K.; MOURA, Diogo T. H. de; SOUZA, Thiago F. de; CAMPOS, Josemberg Marins; SANTO, Marco Aurelio; MOURA, Eduardo G. H. deFistula development is a serious complication after bariatric surgery. We performed a systematic review and meta-analysis to assess the efficacy of fistula closure and complications associated with endoscopic stent treatment of fistulas, developed after bariatric surgeries, particularly Roux-en-Y gastric bypass (RYGB) and gastric sleeve (GS). Studies involving patients with fistula after RYGB or GS and those who received stent treatment only were selected. The analyzed outcomes were overall success rate of fistula closure, mean number of stents per patient, mean stent dwelling time, and procedure-associated complications. Current evidence from identified studies demonstrates that, in selected patients, endoscopic stent treatment of fistulas after GS or RYGB can be safe and effective.
- Pancreatitis after endoscopic retrograde cholangiopancreatography: A narrative review(2021) RIBEIRO, Igor Braga; MONTE JUNIOR, Epifanio Silvino do; MIRANDA NETO, Antonio Afonso; PROENCA, Igor Mendonca; MOURA, Diogo Turiani Hourneaux de; MINATA, Mauricio Kazuyoshi; IDE, Edson; SANTOS, Marcos Eduardo Lera dos; LUZ, Gustavo de Oliveira; MATUGUMA, Sergio Eiji; CHENG, Spencer; BARACAT, Renato; MOURA, Eduardo Guimaraes Hourneaux deAcute post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is a feared and potentially fatal complication that can be as high as up to 30% in high-risk patients. Pre-examination measures, during the examination and after the examination are the key to technical and clinical success with a decrease in adverse events. Several studies have debated on the subject, however, numerous topics remain controversial, such as the effectiveness of prophylactic medications and the amylase dosage time. This review was designed to provide an update on the current scientific evidence regarding PEP available in the literature.
- Laparoscopic Greater Curvature Plication and Laparoscopic Sleeve Gastrectomy Treatments for Obesity: Systematic Review and Meta-Analysis of Short- and Mid-Term Results(2018) BARRICHELLO, Sergio; MINATA, Mauricio Kazuyoshi; GORDEJUELA, Amador Garcia Ruiz de; BERNARDO, Wanderley Marques; SOUZA, Thiago Ferreira de; GALVO NETO, Manoel; MOURA, Diogo Turiani Hourneaux de; SANTO, Marco Aurelio; MOURA, Eduardo Guimares Hourneaux deLaparoscopic greater curvature plication (LGP) has recently emerged as a new bariatric procedure. This surgery provides gastric restriction without resection, which could potentially provide a lower risk alternative, with fewer complications. The real benefit of this technique in the short and long term is unknown. This systematic review aims to compare laparoscopic gastric plication and laparoscopic sleeve gastrectomy for obesity treatment. Clinical trials were identified in MEDLINE, Embase, Cochrane, LILACS, BVS, SCOPUS, and CINAHL databases. Comparison of LGP and laparoscopic sleeve gastrectomy (SG) included hospital stay, operative time, loss of hunger feeling, body mass index loss (BMIL), percentage of excess weight loss (%EWL), complications, symptoms in the postoperative period, and comorbidity remission or improvement. This systematic review search included 17,423 records. Eight studies were selected for meta-analysis. There is no difference in operative time, hospital stay, and complications. Patients in the SG group had improved loss of hunger feeling. BMIL was better in the SG group at 12 and 24 months [mean difference (MD) - 2.19, 95% confidence interval (CI) - 3.10 to - 1.28, and MD - 4.59, 95% CI - 5.55 to - 3.63, respectively]. SG showed improved %EWL compared with gastric plication in 3, 6, 12, and 24 months. However, no difference was found in %EWL long-term results (24 and 36 months). Patients who underwent LGP had more sialorrhea. SG showed better results in diabetes remission. SG showed improved weight loss when compared with LGP, with better satiety, fewer symptoms in the postoperative period, and improved diabetes remission.
- Exclusively endoscopic approach to treating gastric perforation caused by an intragastric balloon: case series and literature review(2018) BARRICHELLO JUNIOR, Sergio Alexandre; RIBEIRO, Igor Braga; FITTIPALDI-FERNANDEZ, Ricardo Jose; HOFF, Ana Carolina; MOURA, Diogo Turiani Hourneaux de; MINATA, Mauricio Kazuyoshi; SOUZA, Thiago Ferreira de; GALVAO NETO, Manoel dos Passos; MOURA, Eduardo Guimaraes Hourneaux deBackground and study aims Obesity is a serious disease, resulting in significant morbidity and mortality. Intragastric balloons (IGBs) have been in use since the 1980s. After the insertion of an IGB, complications such as migration of the device and even severe gastric perforation can occur, requiring laparoscopic surgery. Here, we report three cases of gastric perforation after IGB insertion. In all three cases, the perforation was successfully repaired through an exclusively endoscopic approach.
- Stents and surgical interventions in the palliation of gastric outlet obstruction: a systematic review(2016) MINATA, Mauricio Kazuyoshi; BERNARDO, Wanderley Marques; ROCHA, Rodrigo Silva de Paula; MORITA, Flavio Hiroshi Ananias; AQUINO, Julio Cesar Martins; CHENG, Spencer; ZILBERSTEIN, Bruno; SAKAI, Paulo; MOURA, Eduardo Guimaraes Hourneaux deBackground and study aims: Palliative treatment of gastric outlet obstruction can be done with surgical or endoscopic techniques. This systematic review aims to compare surgery and covered and uncovered stent treatments for gastric outlet obstruction (GOO). Patients and methods: Randomized clinical trials were identified in MEDLINE, Embase, Cochrane, LILACs, BVS, SCOPUS and CINAHL databases. Comparison of covered and uncovered stents included: technical success, clinical success, complications, obstruction, migration, bleeding, perforation, stent fracture and reintervention. The outcomes used to compare surgery and stents were technical success, complications, and reintervention. Patency rate could not be included because of lack of uniformity of the extracted data. Results: Eight studies were selected, 3 comparing surgery and stents and 5 comparing covered and uncovered stents.The meta-analysis of surgical and endoscopic stent treatment showed no difference in the technical success and overall number of complications. Stents had higher reintervention rates than surgery (RD: 0.26, 95% CI [0.05, 0.47], NNH: 4). There is no significant difference in technical success, clinical success, complications, stent fractures, perforation, bleeding and the need for reintervention in the analyses of covered and uncovered stents. There is a higher migration rate in the covered stent therapy compared to uncovered self-expanding metallic stents (SEMS) in the palliation of malignant GOO (RD: 0.09, 95% CI [0.04, 0.14], NNH: 11). Nevertheless, covered stents had lower obstruction rates (RD: -0.21, 95% CI [-0.27,-0.15], NNT: 5). Conclusions: In the palliation of malignant GOO, covered SEMS had higher migration and lower obstruction rates when compared with uncovered stents. Surgery is associated with lower reintervention rates than stents.