IGOR BRAGA RIBEIRO
Projetos de Pesquisa
Unidades Organizacionais
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- The feared postdilation complication in caustic esophageal stenosis: combined endoscopic and surgical treatment(2021) SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; PONTE NETO, Alberto Machado da; MATUGUMA, Sergio Eiji; CHENG, Spencer; SANTOS, Marcos Eduardo Lera dos; MOURA, Eduardo Guimaraes Hourneaux de
- Pain relief in chronic pancreatitis: endoscopic or surgical treatment? a systematic review with meta-analysis(2021) MENDIETA, Pastor Joaquin Ortiz; SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; MOURA, Diogo Turiani Hourneaux de; SCATIMBURGO, Maria Vitoria Cury Vieira; HIRSCH, Bruno Salomao; ROCHA, Rodrigo Silva de Paula; VISCONTI, Thiago Arantes de Carvalho; SANCHEZ-LUNA, Sergio A.; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBackground and aims Pain is one of the consequences of chronic pancreatitis (CP) that has the greatest impact on the quality of life of patients. Endoscopic and surgical interventions, by producing a decrease in intraductal pancreatic pressure, can provide pain relief. This is the first systematic review that includes only randomized clinical trials (RTCs) comparing outcomes in the short-term (less than 2 years) and long-term (more than 2 years) between these two types of interventions. Material and methods A comprehensive search of multiple electronic databases to identify RTCs comparing short and long-term pain relief, procedural complications, and days of hospitalization between endoscopic and surgical interventions was performed following the PRISMA guidelines. Results Three RCTs evaluating a total of 199 patients (99 in the endoscopy group and 100 in the surgery group) were included in this study. Surgical interventions provided complete pain relief, with statistical difference, in the long-term (16,4% vs 35.7%; RD 0.19; 95% CI 0.03-0.35; p = 0.02; I2 = 0%), without significant difference in short-term (17.5% vs 31.2%; RD 0.14; 95% CI -0.01-0.28; p = 0.07; I2 = 0%) when compared to endoscopy. There was no statistical difference in short-term (17.5% vs 28.1%; RD 0.11; 95% CI -0.04-0.25; p = 0.15; I2 = 0%) and long-term (34% vs 41.1%; RD 0.07; 95% CI -0.10-0.24; p = 0.42; I2 0%) in partial relief of pain between both interventions. In the short-term, both complications (34.9% vs 29.7%; RD 0.05; 95% CI -0.10-0.21; p = 0.50; I2 = 48%) and days of hospitalization (MD -1.02; 95% CI -2.61-0.58; p = 0.21; I2 = 0%) showed no significant differences. Conclusion Surgical interventions showed superior results when compared to endoscopy in terms of complete long-term pain relief. The number of complications and length of hospitalization in both groups were similar.
- Endoscopic stag beetle knife treatment for symptomatic Zenker's diverticulum(2021) MONTE, Epifanio Silvino do; IDE, Edson; SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; FUNARI, Mateus Pereira; OLIVEIRA, Pedro Victor Aniz Gomes de; MOURA, Eduardo Guimaraes Hourneaux de
- Gastrointestinal Manifestations and Associated Health Outcomes of COVID-19: A Brazilian Experience From the Largest South American Public Hospital(2020) MOURA, Diogo Turiani Hourneaux de; PROENCA, Igor Mendonca; MCCARTY, Thomas R.; SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; OLIVEIRA, Guilherme Henrique Peixoto de; SOUZA, Gabriel Mayo Vieira de; HIRSCH, Bruno Salomao; SCATIMBURGO, Maria Vitoria Cury Vieira; THOMPSON, Christopher C.; CARRILHO, Flair Jose; CECCONELLO, Ivan; MOURA, Eduardo Guimaraes Hourneaux deOBJECTIVES: Brazil has rapidly developed the second-highest number of COVID-19 cases in the world. As such, proper symptom identification, including gastrointestinal manifestations, and relationship to health outcomes remains key. We aimed to assess the prevalence and impact of gastrointestinal symptoms associated with COVID-19 in a large quaternary referral center in South America. METHODS: This was a single-center cohort study in a COVID-19 specific hospital in Sao Paulo, Brazil. Consecutive adult patients with laboratory confirmed SARS-CoV-2 were included. Baseline patient history, presenting symptoms, laboratory results, and clinically relevant outcomes were recorded. Regression analyses were performed to determine significant predictors of the gastrointestinal manifestations of COVID-19 and hospitalization outcomes. RESULTS: Four-hundred patients with COVID-19 were included. Of these, 33.25% of patients reported gastrointestinal symptom. Diarrhea was the most common gastrointestinal symptom (17.25%). Patients with gastrointestinal symptoms had higher rates of concomitant constitutional symptoms, notably fatigue and myalgia (p <0.05). Gastrointestinal symptoms were also more prevalent among patients on chronic immunosuppressants, ACE/ARB medications, and patient with chronic kidney disease (p <0.05). Laboratory results, length of hospitalization, ICU admission, ICU length of stay, need for mechanical ventilation, vasopressor support, and in-hospital mortality did not differ based upon gastrointestinal symptoms (p> 0.05). Regression analyses showed older age [OR 1.04 (95% CI, 1.02-1.06)], male gender [OR 1.94 (95% CI, 1.12-3.36)], and immunosuppression [OR 2.60 (95% CI, 1.20-5.63)], were associated with increased mortality. CONCLUSION: Based upon this Brazilian study, gastrointestinal manifestations of COVID-19 are common but do not appear to impact clinically relevant hospitalization outcomes including the need for ICU admission, mechanical ventilation, or mortality.
- Endoscopic resection of esophageal and gastric submucosal tumors from the muscularis propria layer: submucosal tunneling endoscopic resection versus endoscopic submucosal excavation: A systematic review and meta-analysis(2021) PONTE NETO, Fernando Lopes; MOURA, Diogo Turiani Hourneaux de; SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; MANCINI, Fabio Catache; BOGHOSSIAN, Mateus Bond; MCCARTY, Thomas R.; MIYAJIMA, Nelson Tomio; IDE, Edson; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBackground Submucosal tunneling endoscopic resection (STER) and endoscopic submucosal excavation (ESE) are less-invasive therapeutic alternatives to surgical resection for the removal of esophageal or gastric submucosal tumors (SMTs). This study aimed to comparing STER versus ESE for the resection of esophageal and gastric SMTs from the muscularis propria. Methods This systematic review and meta-analysis was reported in accordance with PRISMA guidelines through December 2020. Pooled outcome measures included complete resection, en bloc resection, bleeding, perforation, adverse events, recurrence, procedure duration, and length of hospital stay. Risk ratio (RR) and mean difference (MD) was calculated as well as Peto time-to-event analyses to determine recurrence rate. Results Five retrospective cohort studies (n = 269 STER versus n = 319 ESE) were included. There was no difference in rates of complete resection [RR: 1.01 (95% CI 0.94, 1.07)], en bloc resection [RR: 0.95 (95% CI 0.84, 1.08)], recurrence [OR: 1.18 (95% CI 0.33, 4.16)], and total adverse events [RR: 1.33 (95% CI 0.78, 2.27)]. Specific adverse events including rates of perforation [RR: 0.57 (95% CI 0.12, 2.74)] and bleeding [RR: 1.21 (95% CI 0.30, 4.88)] were not different between STER and ESE. There was a statistical difference when evaluating procedure time, with the STER group presenting significantly larger values [MD: 24.62 min (95% CI 20.04, 29.20)]. Conclusion STER and ESE were associated with similar efficacy and safety; however, ESE was associated with a significantly decreased time to complete the procedure.
- 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 deY 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.
- Endoscopic submucosal dissection versus transanal endoscopic surgery for the treatment of early rectal tumor: a systematic review and meta-analysis(2020) SAGAE, Vitor Massaro Takamatsu; RIBEIRO, Igor Braga; MOURA, Diogo Turiani Hourneaux de; BRUNALDI, Vitor Ottoboni; LOGIUDICE, Fernanda Prado; FUNARI, Mateus Pereira; BABA, Elisa Ryoka; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBackground Minimally invasive treatment of early-stage rectal lesion has presented good results, with lower morbidity than surgical resection. Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) are the main methods of transanal surgery. However, endoscopic submucosal dissection (ESD) has been gaining ground because it allows en bloc resections with low recurrence rates. The aim of this study was to analyze ESD in comparison with transanal endoscopic surgery. Methods We searched MEDLINE, EMBASE, SciELO, Cochrane CENTRAL, and Lilacs/Bireme with no restrictions on the date or language of publication. The outcomes evaluated were recurrence rate, complete (R0) resection rate, en bloc resection rate, length of hospital stay, duration of the procedure, and complication rate. Results Six retrospective cohort studies involving a collective total of 326 patients-191 in the ESD group and 135 in the transanal endoscopic surgery group were conducted. There were no statistically significant differences between the groups for any of the outcomes evaluated. Conclusions For the minimally invasive treatment of early rectal tumor, ESD and surgical techniques do not differ in terms of local recurrence, en bloc resection rate, R0 resection rate, duration of the procedure, length of hospital stay, or complication rate, however, evidence is very low.
- Endoscopic treatment of gastric antral vascular ectasia(2022) HIRSCH, Bruno Salomao; RIBEIRO, Igor Braga; FUNARI, Mateus Pereira; SAGAE, Vitor Massaro Takamatsu; MANCINI, Fabio Catache; OLIVEIRA, Guilherme Henrique Peixoto de; MOURA, Eduardo Guimaraes Hourneaux de; BERNARDO, Wanderley MarquesThe Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field, to standardize how to conduct, and to assist in the reasoning and decision-making of doctors. The information provided by this project must be critically evaluated by the physician responsible for the conduct that will be adopted depending on the conditions and the clinical condition of each patient.
- A novel and feasible technique for diagnosis and treatment of small subepithelial tumors(2021) MONTE JUNIOR, Epifanio Silvino do; CHAVES, Dalton Marques; SAKAI, Christiano Makoto; LUZ, Gustavo de Oliveira; RIBEIRO, Igor Braga; SAGAE, Vitor Massaro Takamatsu; MOURA, Eduardo Guimaraes Hourneaux de
- Metabolic Effects of Endoscopic Duodenal Mucosal Resurfacing: a Systematic Review and Meta-analysis(2021) OLIVEIRA, Guilherme Henrique Peixoto de; MOURA, Diogo Turiani Hourneaux de; FUNARI, Mateus Pereira; MCCARTY, Thomas R.; RIBEIRO, Igor Braga; BERNARDO, Wanderley Marques; SAGAE, Vitor Massaro Takamatsu; FREITAS JR., Joao Remi; SOUZA, Gabriel Mayo de Vieira; MOURA, Eduardo Guimaraes Hourneaux deDuodenal mucosal resurfacing (DMR) is an innovative endoscopic bariatric and metabolic therapy (EBMT) emerging in recent years. It uses the duodenum to achieve better glycemic and weight control. This study aimed to evaluate in a critical and systematic way the metabolic effects of this procedure. Electronic searches were performed evaluating the DMR procedure based on predefined inclusion and exclusion criteria. Changes in measured outcomes were evaluated using random-effects models by computing weighted mean differences (MD) and corresponding 95% CIs between pre-and post-procedure metabolic characteristics. Four studies were selected for qualitative and quantitative analysis. DMR demonstrated beneficial glycemic and hepatic metabolic effects among patients with non-insulin dependent type 2 diabetes (T2D) at 3 and 6 months post-procedure.