FRANCISCO TUSTUMI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass in the Elderly: 1-Year Preliminary Outcomes in a Randomized Trial (BASE Trial)(2021) PAJECKI, Denis; DANTAS, Anna Carolina Batista; TUSTUMI, Francisco; KANAJI, Ana Lumi; CLEVA, Roberto de; SANTO, Marco AurelioPurpose Despite the increasing prevalence of elderly obese patients, bariatric surgery remains controversial in this population. Recent publications have focused on perioperative safety, but few studies have addressed clinical outcomes. Objectives This study aimed to evaluate 1-year outcomes of laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients 65 years or older. Methods Thirty-six elderly obese patients were recruited for an open-label randomized trial from September 2017 to May 2019, comparing LSG to LRYGB. One-year outcomes were evaluated based on weight loss, functionality, and control of clinical conditions. Results The median age (67 x 67 years; p=0.67) and initial body mass index (BMI) (46.3 x 51.3 kg/m(2); p=0.28) were similar between groups. Preoperative BMI (after weight loss pre-operative treatment) was higher in LRYGB group (41.9 x 47.6 kg/m(2); p= 0.03). After 12 months, EWL and TWL were higher in LRYGB group (60 x 68%; p=0.04; 24.9 x 31.4%; p<0.01). HbA1c reduction was higher after LRYGB (-1.1 x -0.5%; p<0.01) as well as LDL control (-27.5 x +11.5 mg/dL p= 0.02). No difference was noted between LRYGB and LSG concerning hypertension control, triglycerides, HDL, and functionality. Conclusion Weight loss, diabetes, and LDL control were better achieved with LRYGB after 12 months.
- Efficacy and Safety of Endoscopic Sleeve Gastroplasty at Mid Term in the Management of Overweight and Obese Patients: a Systematic Review and Meta-Analysis(2020) MIRANDA NETO, Antonio Afonso de; MOURA, Diogo Turiani Hourneaux de; RIBEIRO, Igor Braga; KHAN, Ahmad; SINGH, Shailendra; PONTE NETO, Alberto Machado da; MADRUGA NETO, Antonio Coutinho; MONTE JUNIOR, Epifanio Silvino do; TUSTUMI, Francisco; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBackground Endoscopic sleeve gastroplasty (ESG) has emerged as a promising technique in endoscopic bariatric and metabolic therapies (EBMTs). We aimed to perform a systematic review and meta-analysis to provide an update on its efficacy and safety. Methods This is a systematic review and meta-analysis was performed following the PRISMA guidelines. MEDLINE, Cochrane, EMBASE, and LILACS were searched to identify the studies related to ESG. Results Eleven studies with a total of 2170 patients were included. The average BMI pre-ESG was 35.78 kg/m(2). Pooled mean %TWL observed at 6, 12, and 18 months was 15.3%, 16.1%, and 16.8% respectively. Pooled mean %EWL at 6, 12, and 18 months was 55.8%, 60%, and 73% respectively. No procedure-related mortality was reported. Conclusion ESG is a safe and effective procedure for primary obesity therapy with promising short- and mid-term results.
- Cholecystectomy in Patients Submitted to Bariatric Procedure: A Systematic Review and Meta-analysis(2018) TUSTUMI, Francisco; BERNARDO, Wanderley M.; SANTO, Marco A.; CECCONELLO, IvanWeight loss following bariatric surgery increases risk for biliary stones. This study performed a meta-analysis evaluating cholecystectomy risks in bariatric patients. A systematic review and meta-analysis were performed. We evaluated the incidence rate for biliary complications in patients followed after bariatric surgery. We compared the risks for mortality, complications, and in hospital stay among patient submitted to cholecystectomy before, concomitantly with or after bariatric surgery, as well as patients submitted to bariatric surgery and cholecystectomy, and patients submitted only to bariatric surgery in order to evaluate when to perform cholecystectomy in morbidly obese patients. The incidence rate of biliary complications was 5.54 cases/1000 patient year. The addition of cholecystectomy to bariatric surgery resulted in an increased risk for complications (RD = 0.02). The risk for complications (RD = - 0.09) and reoperation (RD = - 0.02) was lower when performed concomitantly with bariatric surgery compared to post-bariatric procedure. Prophylactic cholecystectomy may be avoided. Patients submitted to bariatric surgery have low incidence rate of biliary complications, and concomitant cholecystectomy increases the risk for postoperative complications and operative time. If cholecystectomy is not indicated, patients should be carefully followed with attention for biliary complications, once cholecystectomy performed post-bariatric surgery is at higher risk for complications and reoperations.
- One-Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass as Revisional Surgery After Sleeve Gastrectomy: a Systematic Review and Meta-analysis(2022) DANTAS, Anna Carolina Batista; BRANCO, Leonardo Torres; TUSTUMI, Francisco; OLIVEIRA, Daniel Riccioppo Cerqueira Ferreira de; PAJECKI, Denis; SANTO, Marco AurelioThe demand for revisional bariatric surgery after sleeve gastrectomy (SG) has increased, but the ideal procedure remains unclear. A systematic review and meta-analysis were performed to compare the outcomes of weight loss and safety of one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) as revisional procedures for failed SG. Four retrospective comparative studies were included, comprising 499 individuals. Patients submitted to OAGB had a more significant total weight loss (TWL) (MD = - 5.89%; 95% CI - 6.80 to - 4.97) after revisional surgery. Overall early complication rate was similar between procedures (RD = 0.04; 95% CI: - 0.05 to 0.12). Limited and heterogeneous data prevent meaningful conclusions, but the present analysis suggests that OAGB has a better TWL after revisional surgery.
- Scores for Predicting Diabetes Remission in Bariatric Surgery: a Systematic Review and Meta-analysis(2023) SESCONETTO, Lucas de Abreu; SILVA, Rafael Benjamim Rosa da; GALLETTI, Ricardo Purchio; AGARENO, Gabriel Andrade; COLONNO, Barbara Buccelli; SOUSA, Jorge Henrique Bento de; TUSTUMI, FranciscoThis systematic review aims to compare the accuracy of pre-existent scores predicting diabetes remission after bariatric and metabolic surgery. Among the scores, DiaBetter presented the largest area under the curve (AUC) (0.87; 95% CI, 0.84-0.9). Ad-DiaRem had the lowest AUC (0.79; 95% CI, 0.76-0.83). Ad-DiaRem showed the highest sensitivity (91%; 95% CI, 86-96%), with a specificity of 71.23% (95% CI 50.43 to 92.06%). IMS showed a sensitivity of 59% (95% CI, 20-90%), with the highest specificity (86%; 95% CI, 69-94%). Clinicians should associate the findings of the present review with patients' individual characteristics to help predict diabetes remission and evaluate the probability of the patient benefit from surgery.
- Gastric Bypass Compared with Sleeve Gastrectomy for Nonalcoholic Fatty Liver Disease: a Systematic Review and Meta-analysis(2021) SILVA, Miller Barreto de Brito e; TUSTUMI, Francisco; MIRANDA NETO, Antonio Afonso de; DANTAS, Anna Carolina Batista; SANTO, Marco Aurelio; CECCONELLO, IvanThe effects of bariatric procedures on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) remain unclear. A systematic review and meta-analysis was performed to compare the impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on NAFLD/NASH. Patients submitted to RYGB presented significant reduction of steatohepatitis (RD: 0.53; 95% CI 0.33 to 0.74) and fibrosis (RD: 0.26; 95% CI 0.14 to 0.37). SG caused a significant reduction of steatohepatitis (RD: 0.42; 95% CI 0.27 to 0.57), but not of fibrosis (RD: 0.20; 95% CI -0.00 to 0.39). The NAFLD Activity Score was significantly improved after both procedures, as well as biochemical tests. No difference was found between RYGB and SG regarding the histopathological outcomes. SG and RYGB are equivalently effective for treating NAFLD/NASH.