DANIEL RICCIOPPO CERQUEIRA FERREIRA DE OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
22 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 22
- Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0?(2023) BRUNALDI, Vitor Ottoboni; OLIVEIRA, Guilherme Henrique Peixoto de; KERBAGE, Anthony; RIBAS, Pedro Henrique; NUNES, Felipe; FARIA, Galileu; MOURA, Diogo de; RICCIOPPO, Daniel; SANTO, Marco; MOURA, Eduardo deBackground and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the short term. However, no study has investigated the course of gastrojejunostomy (GJ) or quality of life (QOL) data after the first post-procedure year.Patients and methods Patients eligible for a 36-month follow-up visit after TORe underwent upper gastrointestinal endoscopy with measurement of the GJ and answered QOL questionnaires (RAND-36). The primary aim was to evaluate the long-term outcomes of TORe, including weight loss, QOL, and GJ anastomosis (GJA) size. Comparisons between APC and APC-FTS TORe were a secondary aim.Results Among 39 eligible patients, 29 returned for the 3-year follow-up visit. There were no significant differences in demographics between APC and APC-FTS TORe groups. At 3 years, patients from both groups regained all the weight lost at 12 months, and the GJ diameter was similar to the pre-procedure assessment. As to QOL, most improvements seen at 12 months were lost at 3 years, returning to pre-procedure levels. Only the energy/fatigue domain improvement was kept between the 1- and 3-year visits.Conclusions Obesity is a chronic relapsing disease. Most effects of TORe are lost at 3 years, and redilation of the GJA occurs. Therefore, TORe should be considered iterative rather than a one-off procedure.
- Preoperative weight loss in super-obese patients: study of the rate of weight loss and its effects on surgical morbidity(2014) SANTO, Marco Aurelio; RICCIOPPO, Daniel; PAJECKI, Denis; CLEVA, Roberto de; KAWAMOTO, Flavio; CECCONELLO, IvanOBJECTIVES: The incidence of obesity and particularly super obesity, has increased tremendously. At our institution, super obesity represents 30.1% of all severely obese individuals in the bariatric surgery program. In super obesity, surgical morbidity is higher and the results are worse compared with morbid obesity, independent of the surgical technique. The primary strategy for minimizing complications in these patients is to decrease the body mass index before surgery. Preoperative weight reduction can be achieved by a hypocaloric diet, drug therapy, an intragastric balloon, or hospitalization. The objective of this study was to analyze the results of a period of hospitalization for preoperative weight loss in a group of super-obese patients. METHODS: Twenty super-obese patients were submitted to a weight loss program between 2006 and 2010. The mean patient age was 46 years (range 21-59). The mean BMI was 66 kg/m(2) (range 51-98) and 12 were women. The average hospital stay was 19.9 weeks and the average weight loss was 19% of the initial weight (7-37%). The average caloric intake was 5 kcal/kg/day. After the weight loss program, the patients underwent gastric bypass surgery. RESULTS: The statistical analysis revealed that after 14 weeks of treatment (15% loss of initial weight), the weight loss was not significant. All patients had satisfactory surgical recovery and were discharged after an average of 4.6 days. CONCLUSION: In super obesity, preoperative weight loss is an important method for reducing surgical risks. Hospitalization and a hypocaloric diet are safe and effective. After 14 weeks, the weight loss rate stabilized, signaling the time of surgical intervention in our study.
- EARLY COMPLICATIONS IN BARIATRIC SURGERY: incidence, diagnosis and treatment(2013) SANTO, Marco Aurelio; PAJECKI, Denis; RICCIOPPO, Daniel; CLEVA, Roberto; KAWAMOTO, Flavio; CECCONELLO, IvanContext Bariatric surgery has proven to be the most effective method of treating severe obesity. Nevertheless, the acceptance of bariatric surgery is still questioned. The surgical complications observed in the early postoperative period following surgeries performed to treat severe obesity are similar to those associated with other major surgeries of the gastrointestinal tract. However, given the more frequent occurrence of medical comorbidities, these patients require special attention in the early postoperative follow-up. Early diagnosis and appropriate treatment of these complications are directly associated with a greater probability of control. Method The medical records of 538 morbidly obese patients who underwent surgical treatment (Roux-en-Y gastric bypass surgery) were reviewed. Ninety-three (17.2%) patients were male and 445 (82.8%) were female. The ages of the patients ranged from 18 to 70 years (average = 46), and their body mass indices ranged from 34.6 to 77 kg/m2. Results Early complications occurred in 9.6% and were distributed as follows: 2.6% presented bleeding, intestinal obstruction occurred in 1.1%, peritoneal infections occurred in 3.2%, and 2.2% developed abdominal wall infections that required hospitalization. Three (0.5%) patients experienced pulmonary thromboembolism. The mortality rate was 0,55%. Conclusion The incidence of early complications was low. The diagnosis of these complications was mostly clinical, based on the presence of signs and symptoms. The value of the clinical signs and early treatment, specially in cases of sepsis, were essential to the favorable surgical outcome. The mortality was mainly related to thromboembolism and advanced age, over 65 years.
conferenceObject Systematic Review and Meta-Analysis of the Endoscopic Treatment for Weight Regain Following Roux-En-Y Gastric Bypass and the Role of Argon Plasma Coagulation Prior to Endoscopic Suture(2017) BRUNALDI, Vitor O.; BERNARDO, Wanderlei M.; OKAZAKI, Ossamu; MARINHO, Fabio R.; MOURA, Diogo T. de; RICCIOPPO, Daniel; SANTO, Marco Aurelio; GALVAO NETO, Manoel; MOURA, Eduardo G. deconferenceObject ANEMIA BEFORE AND AFTER BARIATRIC SURGERY: PREVALENCE AND EVOLUTION ON LONG-TERM FOLLOW UP(2015) SANTO, Marco; FUKUMOTO, Miwa; KANASHIRO, Newton; CURADO, Taina; DANTAS, Anna; JOAQUIM, Henrique; GARMS, Alan; RICCIOPPO, Daniel; CLEVA, Roberto; CECCONELLO, IvanconferenceObject LATE POSTOPERATIVE OUTCOME OF ROUX-EN-Y GASTRIC BYPASS IN MORBIDLY OBESE PATIENTS - ANALYSIS OF THE INFLUENCE OF GASTROINTESTINAL HORMONES IN WEIGHT REGAIN(2015) SANTO, Marco; RICCIOPPO, Daniel; PAJECKI, Denis; KAWAMOTO, Flavio; JOAQUIM, Henrique; CLEVA, Roberto; ANTONANGELO, Leila; MARCAL, Lia; GARMS, Alan; CECCONELLO, IvanconferenceObject ROBOTIC REVISIONAL GASTRIC BYPASS: POUCH ""REDO"" AND HIATAL HERNIA REPAIR(2015) PAJECKI, Denis; SANTO, Marco Aurelio; PUZZO, Daniel Bauab; JOAQUIM, Henrique; RICCIOPPO, Daniel- Argon plasma coatmlation alone versus argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass: a prospective randomized trial (with videos)(2020) BRUNALDI, Vitor Ottoboni; FARIAS, Galileu Ferreira Ayala; REZENDE, Daniel Tavares de; CAIRO-NUNES, Gabriel; RICCIOPPO, Daniel; MOURA, Diogo Turiani Hourneaux de; SANTO, Marco Aurelio; MOURA, Eduardo Guimaraes Hourneaux deBackground and Aims: A significant number of patients regain weight after Roux-en-Y gastric bypass. Ablation with argon plasma coagulation (APC) plus endoscopic full-thickness suturing (FTS-APC) and ablation alone have been reported for treating weight regain when associated with gastrojejunostomy (GJ) dilation. However, comparative controlled data are still lacking. Methods: This was a pilot single-center open-label randomized trial comparing the effectiveness and safety of APC alone versus FTS-APC for transoral outlet reduction. Patients with at least 20% weight regain from the nadir, and GJ >= 15 mm were considered eligible. The primary outcome was percentage total weight loss (%TWL) at 12 months. Secondary outcomes were the incidence of adverse events, amelioration of metabolic laboratory parameters, and improvement in quality of life and eating behavior. Results: Forty patients meeting the eligibility criteria were enrolled from October 2017 to July 2018. Technical and clinical success rates were similar between the groups. At 12 months, the mean %TWL was 8.3% +/- 5.5% in the APC alone group versus 7.5% +/- 7.7% in the Fl S-APC group (P = .71). The pre-revisional % solid gastric retention at 1 hour positively correlated with the probability of achieving >= 10% TWL at 12 months. Both groups experienced significant reductions in low-density lipoprotein and triglyceride levels at 12 months, and improvement in eating behavior and quality of life at 3 months. There were 2 cases of stenoses (1 from each group), which were successfully treated with endoscopic balloon dilation. Conclusion: APC alone is similar to FTS-APC in terms of technical and clinical outcomes within 1 year of followup.
conferenceObject ENDOSCOPIC VACUUM THERAPY FOR ESOPHAGEAL POST-MEGASTENT PERFORATION.(2018) BRUNALDI, Vitor O.; RICCIOPPO, Daniel; MOURA, Diogo T. de; MINATA, Mauricio K.; MORITA, Flavio Hiroshi A.; ROCHA, Rodrigo S.; FARIAS, Galileu F.; SANTO, Marco Aurelio; MOURA, Eduardo G. de- FULL-THICKNESS ENDOSCOPIC SUTURING PLUS APC VERSUS APC ALONE TO TREAT WEIGHT REGAIN FOLLOWING ROUX-EN-Y GASTRIC BYPASS: AN INTERIM ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL(2019) BRUNALDI, Vitor O.; FARIAS, Galileu F.; REZENDE, Daniel T.; NUNES, Gabriel C.; MOURA, Diogo T. de; NETO, Manoel Galvao; SOUZA, Thiago F.; RICCIOPPO, Daniel; SANTO, Marco Aurelio; MOURA, Eduardo G. de
- «
- 1 (current)
- 2
- 3
- »