JOAO PAULO AGUIAR RIBEIRO

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  • conferenceObject
    Results of Endoscopic Cyanoacrylate Injection for the Treatment of Esophageal Variceal Hemorrhage in Child-Pugh C Patients
    (2012) RIBEIRO, Joao Paulo A.; MALUF-FILHO, Fauze; MATUGUMA, Swrgio E.; HERMAN, Paulo; SAKAI, Paulo; D'ALBUQUERQUE, Luiz Augusto C.
  • article 4 Citação(ões) na Scopus
    PEG rescue with gastropexy after early tube withdrawal: an application of natural orifice transluminal endoscopic surgery (with video)
    (2011) MARTINS, Bruno da Costa; TAKADA, Jonas; KAWAGUTI, Fabio Shiguehissa; RIBEIRO, Joao Paulo Aguiar; HONDO, Fabio Yuji; LIMA, Marcelo Simas de; NEVES, Carla Zanellatto; NAHAS, Caio Sergio R.; MARQUES, Carlos Frederico Sparapan; SAKAI, Paulo; MALUF-FILHO, Fauze
  • article
    Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis
    (2015) RIBEIRO, Joao Paulo; MATUGUMA, Sergio Eiji; CHENG, Spencer; HERMAN, Paulo; SAKAI, Paulo; D'ALBUQUERQUE, Luiz Augusto Carneiro; MALUF-FILHO, Fauze
    Background and study aims: The results of endoscopic treatment with elastic band ligation for esophageal variceal bleeding in patients with Child-Pugh class C cirrhosis remain poor. In comparison with treatment with elastic band ligation, we have found lower rates of rebleeding and mortality with n-butyl-2-cyanoacrylate injections. Thus, the aim of the current study was to describe our unit's 10 years of experience with injection of n-butyl-2-cyanoacrylate to control esophageal variceal ruptures in patients with Child-Pugh class C cirrhosis. Patients and methods: A single-center, retrospective study was conducted. Sixty-three patients with Child-Pugh class C cirrhosis had been admitted to the center with an acute episode of esophageal variceal bleeding. All were treated with injection of n-butyl-2-cyanoacrylate. The patients were assigned to 1 of 2 groups according to their Child-Pugh class C cirrhosis scores: group I (score range, 10 through 13 points) and group II (score, 14 or 15 points). The 3 variables studied were rates of initial failure to control bleeding, failure to prevent rebleeding (secondary prophylaxis), and mortality. Patients in the 2 groups (group I, n=50; group II, n=13) had similar characteristics. Results: Bleeding was successfully controlled in almost 75% of the patients during the first 5 days after treatment, with no significant differences observed between groups I and II. There were no significant differences between the 2 groups with respect to mortality rate for the first 5 days after treatment. Thirty-four patients (54%) were free of bleeding at 6 weeks after treatment, with a significant difference noted between the groups: group I, 64%, versus group II, 15.4% (P<0.001). The overall mortality rate was 44.4%, with a significant difference noted between the groups: group I, 34%, versus group II, 84.6% (P<0.001). Conclusion: Endoscopic injection of n-butyl-2-cyanoacrylate is a valid treatment option to control esophageal variceal bleeding in patients with a Child-Pugh class C cirrhosis score in the range of 10 through 13 points.