DALTON MARQUES CHAVES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
42 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 42
conferenceObject Gastric PerOral Endoscopic Myotomy (G-POEM) for Refractory Gastroparesis: Results From the First Multicenter Study on Endoscopic Pyloromyotomy(2016) KHASHAB, Mouen A.; NGAMRUENGPHONG, Saowanee; CARR-LOCKE, David L.; BAPAYE, Amol; BENIAS, Petros C.; SEROUYA, Sam; DUBALE, Nachiket; CHAVES, Dalton M.; ARTIFON, Everson L.; KUMBHARI, Vivek; CHAVEZ, Yamile Haito; BUKHARI, Majidah; HAJIYEVA, Gulara; ISMAIL, Amr; CHEN, Yen-I.; MOURA, Eduardo G. de; CHUNG, HyunsooconferenceObject EUS-FNA OF PANCREATIC SOLID MASSES: A PROSPECTIVE RANDOMIZED TRIAL COMPARING SUCTION WITH SLOW PULL(2018) CHENG, Spencer; DANIELLE, Chacon A.; ARTIFON, Everson L.; MATUGUMA, Sergio E.; SANTOS, Marcos E. dos; SAKAI, Christiano M.; CHAVES, Dalton; MOURA, Diogo T. De; MOURA, Eduardo T.bookPart Diagnóstico e Terapêutica das Afecções Biliopancreáticas: Detecção de Lesões de Papila(2017) MENDONçA, Ernesto Quaresma; MOURA, Eduardo Turiani Hourneaux de; YAMAZAKI, Kendi; CHAVES, Dalton Marques; IDE, Edson- Comprehensive Analysis of Adverse Events Associated with Gastric Peroral Endoscopic Myotomy: An International Multicenter Study(2021) ICHKHANIAN, Y.; VOSOUGHI, K.; MEYBODI, M. Aghaie; JACQUES, J.; SETHI, A.; PATEL, A. A.; AADAM, A. A.; TRIGGS, J. R.; BAPAYE, A.; DORWAT, S.; BENIAS, P.; CHAVES, D. M.; BARRET, M.; LAW, R. J.; BROWERS, N.; PIOCHE, M.; V, P. Draganov; KOTZEV, A.; ESTREMERA, F.; ALBENIZ, E.; UJIKI, M. B.; CALLAHAN, Z. M.; ITANI, I. M.; BREWER, O. G.; KHASHAB, M. A.Background Gastric peroral endoscopic myotomy (G-POEM) has emerged as an effective management approach for patients with refractory gastroparesis. This study aims to comprehensively study the safety of G-POEM and describe the predictive factors of adverse events (AEs) occurrence. Methods This study is a retrospective study involving 13 tertiary care centers (7 USA, 1 South America, 4 Europe, and 1 Asia). Patients who underwent G-POEM for refractory gastroparesis were included. Cases were identified by the occurrence of AEs. For each case, two controls were randomly selected and matched for age (+/- 10 years), gender, and etiology of gastroparesis. Results A total of 216 patients underwent G-POEM for gastroparesis. Overall, 31 (14%) AEs were encountered [mild 24 (77%), moderate 5 (16%), and severe 2 (6%)] during the duration of the study. The most common AE was abdominal pain (n = 16), followed by mucosotomy (n = 5) and capnoperitoneum (n = 4), and AEs were most commonly identified within the first 48-h post-procedure 18 (58%). The risk of adverse event occurrence was significantly higher for endoscopists with experience of < 20 G-POEM procedures (OR 3.03 [1.03-8.94], p < 0.05). Conclusion G-POEM seems to be a safe intervention for refractory gastroparesis. AEs are most commonly mild and managed conservatively. Longitudinal mucosal incision, use of hook knife, use of clips for mucosal closure and endoscopist's experience with > 20 G-POEM procedures is significantly associated with decreased incidence of AEs.
- Suction versus slow-pull for endoscopic ultrasound-guided fine-needle aspiration of pancreatic tumors: a prospective randomized trial(2020) CHENG, Spencer; BRUNALDI, Vitor O.; MINATA, Mauricio K.; CHACON, Danielle A.; SILVEIRA, Eduardo B.; MOURA, Diogo T. H. de; SANTOS, Marcos E. L. Dos; MATUGUMA, Sergio E.; CHAVES, Dalton M.; FRANCA, Raony F.; JACOMO, Alfredo L.; ARTIFON, Everson L. A.Background: Suction (S) is commonly used to improve cell acquisition during endoscopic ultrasoundguided fine-needle aspiration (EUS-FNA). Slow-pull (SP) sampling is another technique that might procure good quality specimens with less bloodiness. We aimed to determine if SP improves the diagnostic yield of EUS-FNA of pancreatic masses. Methods: Patients with pancreatic solid masses were randomized to four needle passes with both techniques in an alternate fashion. Sensitivity, specificity, positive, and negative predictive values were calculated. Cellularity and bloodiness of cytological samples were assessed and compared according to the technique. Results: Sensitivity, specificity, and accuracy of suction vs. SP were 95.2% vs. 92.3%; 100% vs. 100; 95.7% vs. 93%, respectively. As to the association of methods, they were 95.6, 100 and 96%, respectively. Positive predictive values for S and SP were 100%. There was no difference in diagnostic yield between S and SP (p = 0.344). Cellularity of samples obtained with SP and Suction were equivalent in both smear evaluation (p = 0.119) and cell-block (0.980). Bloodiness of SP and suction techniques were similar as well. Conclusions: S and SP techniques provide equivalent sensitivity, specificity, and accuracy. Association of methods seems to improve diagnostic yield. Suction does not increase the bloodiness of samples compared to slow-pull.
conferenceObject Endoscopic Papillary Large Balloon Dilation Associated With Sphincterotomy for Extraction of Large Bile Duct Stones(2012) LUZ, Gustavo O.; MOURA, Eduardo G. De; MEINE, Gilmara C.; CARNEIRO, Fred O.; MEDRADO, Bruno F.; ALMEIDA, Maira R.; MALUF-FILHO, Fauze; LERA, Marcos; IDE, Edson; FURUYA, Carlos K.; CHAVES, Dalton M.; CHENG, Spencer; MATUGUMA, Sergio E.; TOMISHIGE, Toshiro; HONDO, Fabio Y.; BARACAT, Renato; ARTIFON, Everson L.; FRANZINI, Tomazo; SAKAI, PauloCommon bile duct stones larger than 15mm are related to a higher rate of failure of endoscopic ductal clearance and need for mechanical lithotripsy. Recently, endoscopic papillary large balloon dilation (EPLBD) associated with endoscopic sphyncterotomy (ES) has been advocated for the management of difficult bile duct stones. Objective: Evaluate the efficacy and safety of EPLBD associated with ES for removal of large bile duct stones. Patients and methods: retrospective review of prospectively collected data in an academic tertiary referral center, from November 2009 to August 2011. Ampullary dilation was performed with a wire guided hydrostatic balloon (CRE/Boston Scientific) which size ranged from 12 to 20mm. The stone size and the duct diameter directed the choice of the balloon diameter. Balloon was inflated with diluted contrast medium under endoscopic and fluoroscopic control until waist disappearance and/or maximal balloon pressure. After dilation stones were extracted with the aid of standard accessories and techniques. Outcomes and adverse events were recorded. Results: A total of 730 patients with common bile duct stones were admitted for ERCP in our institution. 123 (16,8%) patients were submitted to EPLBD after sphincterotomy. The mean age was 56 years (22-98) and 77 were female (63%). The size of the stones ranged from 13 to 30mm. Initial procedure success rate without mechanical lithitripsy was 83% (102/123). In further 4 patients (3,2%) mechanical lithotripsy was used with 75% success rate (3/4). For the remaining 17 patients, mechanical litotripsy was not available and a 10Fr biliary stent was introduced to prevent obstruction and cholangitis. The total adverse events rate was 3,2%. There were 2 cases of perforation with 20mm balloon (1,6%), both treated conservatively, and two cases of mild acute pancreatitis (1,6%). None of the patients presented bleeding that required transfusion or hospitalization. Conclusion: EPLBD after sphincterotomy is a safe and effective technique for the management of large bile duct stones and it avoids mechanical lithotripsy in the majority of cases.- Endoscopic pyloromyotomy via a gastric submucosal tunnel dissection for the treatment of gastroparesis after surgical vagal lesion(2014) CHAVES, Dalton M.; MOURA, Eduardo G. H. de; MESTIERI, Luiz H. M.; ARTIFON, Everson L.; SAKAI, Paulo
bookPart Diagnóstico e tratamento de lesões císticas do pâncreas(2014) ARTIFON, Everson Luiz de Almeida; CARNEIRO, Fred Olavo Aragão Andrade; CHAVES, Dalton Marques; SOUSA, Marcelo Magno de Freitas- GASTRIC PERORAL ENDOSCOPIC MYOTOMY (G-POEM) IN THE TREATMENT OF REFRACTORY GASTROPARESIS: CASE SERIES AND LITERATURE REVIEW(2019) PONTE, Alberto M. da; SAGAE, Vitor M.; MORITA, Flavio H.; MATSUBAYASHI, Carolina O.; MINATA, Mauricio K.; MOURA, Eduardo T.; SAKAI, Paulo; MOURA, Eduardo G. de; CHAVES, Dalton
bookPart Endoscopia digestiva diagnóstica e terapêutica(2013) SAKAI, Paulo; CHAVES, Dalton Marques; SAFATLE-RIBEIRO, Adriana Vaz; ARTIFON, Everson Luiz; MALUF-FILHO, Fauze; MOURA, Eduardo Guimarães Horneaux de; FERREIRA, Flávio