GUILHERME HENRIQUE PEIXOTO DE OLIVEIRA
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- 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.
- Antibiotic prophylaxis to prevent complications in endoscopic retrograde cholangiopancreatography: A systematic review and meta-analysis of randomized controlled trials(2022) MERCHAN, Maria Fernanda Shinin; MOURA, Diogo Turiani Hourneaux de; OLIVEIRA, Guilherme Henrique Peixoto de; PROENCA, Igor Mendonca; MONTE JUNIOR, Epifanio Silvino do; IDE, Edson; MOLL, Caroline; SANCHEZ-LUNA, Sergio A.; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBACKGROUNDThe prophylactic use of antibiotics in endoscopic retrograde cholangiopancreatography (ERCP) is still controversial.AIMTo assess whether antibiotic prophylaxis reduces the rates of complications in patients undergoing elective ERCP.METHODSThis systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A comprehensive search of multiple electronic databases was performed. Only randomized controlled trials were included. The outcomes analyzed included bacteremia, cholangitis, sepsis, pancreatitis, and mortality. The risk of bias was assessed by the Cochrane revised Risk-of-Bias tool for randomized controlled trials. The quality of evidence was assessed by the Grading of Recommendation Assessment, Development, and Evaluation. Meta-analysis was performed using the Review Manager 5.4 software.RESULTSTen randomized controlled trials with a total of 1757 patients that compared the use of antibiotic and non-antibiotic prophylaxis in patients undergoing elective ERCP were included. There was no significant difference between groups regarding incidence of cholangitis after ERCP [risk difference (RD) = -0.02, 95% confidence interval (CI): -0.05, 0.02, P = 0.32], cholangitis in patients with suspected biliary obstruction (RD = 0.02, 95%CI: -0.08 to 0.13, P = 0.66), cholangitis on intravenous antibiotic prophylaxis (RD = -0.02, 95%CI: -0.05 to 0.01, P = 0.25), septicemia (RD = -0.02, 95%CI: -0.06 to 0.01, P = 0.25), pancreatitis (RD = -0.02, 95%CI: -0.06 to 0.01, P = 0.19), and all-cause mortality (RD = 0.00, 95%CI: -0.01 to 0.01, P = 0.71]. However, the antibiotic prophylaxis group presented a 7% risk reduction in the incidence of bacteremia (RD= -0.07, 95%CI: -0.14 to -0.01, P = 0.03).CONCLUSIONThe prophylactic use of antibiotics in patients undergoing elective ERCP reduces the risk of bacteremia but does not appear to have an impact on the rates of cholangitis, septicemia, pancreatitis, and mortality.
- Endoscopic Band Ligation Versus Argon Plasma Coagulation in the Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials(2021) HIRSCH, Bruno Salomao; RIBEIRO, Igor Braga; FUNARI, Mateus Pereira; MOURA, Diogo Turiani Hourneaux de; MATUGUMA, Sergio Eiji; SANCHEZ-LUNA, Sergio A.; MANCINI, Fabio Catache; OLIVEIRA, Guilherme Henrique Peixoto de; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBackground/Aims: Argon plasma coagulation (APC) is the most commonly used endoscopic treatment for gastric antral vascular ectasia (GAVE). Endoscopic band ligation (EBL) has emerged as an alternative therapy. Our goal was to evaluate the feasibility, efficacy, and safety of APC and EBL for the treatment of GAVE. This is the first systematic review that included only randomized controlled trials (RCTs) on this topic. Methods: A comprehensive search was performed using electronic databases to identify RCTs comparing APC and EBL for the treatment of GAVE following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results: Four RCTs were included, with a total of 204 patients. EBL was related to higher endoscopic eradication rates risk difference [RD], 0.29; 95% confidence interval [CI] [0.14, 0.44]; I-2=0%) and less bleeding recurrence than APC (RD, 0.29; 95% CI [0.15, 0.44]; I-2=0%). Patients treated with EBL required fewer blood transfusions (mean difference [MD], 1.49; 95% CI [0.28, 2.71]; I-2=96%) and hospitalizations (MD, 0.29; 95% CI [0.19, 0.39]; I-2=0%). The number of sessions required for the obliteration of lesions was higher with APC. There was no difference in the incidence of adverse events. Conclusions: EBL is superior to APC in the treatment of GAVE in terms of endoscopic eradication rates, recurrence of bleeding, and transfusion requirements.
conferenceObject ENDOSCOPIC VERSUS RADIOLOGIC GASTROSTOMY FOR ENTERAL FEEDING: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) SANTOS, Evellin dos; OLIVEIRA, Guilherme Henrique Peixoto de; MOURA, Diogo De; HIRSCH, Bruno Salomao; BERNARDO, Wanderley; MOURA, Eduardo De- Endoscopic management of acute leak after sleeve gastrectomy: principles and techniques(2022) MOURA, Diogo Turiani Hourneaux de; FREITAS JUNIOR, Joao Remi de; SOUZA, Gabriel Mayo Vieira de; OLIVEIRA, Guilherme Henrique Peixoto de; MCCARTY, Thomas R.; THOMPSON, Christopher C.; MOURA, Eduardo Guimaraes Hourneaux de
conferenceObject HOT VERSUS COLD SNARE FOR COLORECTAL POLYPECTOMIES SIZED UP TO 10MM. A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) CAVASSOLA, Paulo; HIRSCH, Bruno Salomao; BESTETTI, Alexandre; OLIVEIRA, Guilherme Henrique Peixoto de; GOMES, Romulo; VERAS, Matheus; BERNARDO, Wanderley; MOURA, Diogo De; MOURA, Eduardo De- Tips and tricks in the endoscopic management of a complex biliary stone in Billroth II gastrectomy(2022) OLIVEIRA, Guilherme Henrique Peixoto de; MOURA, Diogo Turiani Hourneaux de; MCCARTY, Thomas R.; OLIVEIRA, Pedro Victor Aniz Gomes de; FUNARI, Mateus Pereira; CHENG, Spencer; MOURA, Eduardo Guimaraes Hourneaux de
- Impact of Endoscopic Sleeve Gastroplasty in Non-alcoholic Fatty Liver Disease: a Systematic Review and Meta-analysis(2023) NUNES, Beanie Conceicao Medeiros; MOURA, Diogo Turiani Hourneaux de; KUM, Angelo So Taa; OLIVEIRA, Guilherme Henrique Peixoto de; HIRSCH, Bruno Salomao; RIBEIRO, Igor Braga; GOMES, Igor Logetto Caetite; OLIVEIRA, Claudia Pinto Marques de; MAHMOOD, Sultan; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deNon-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide. Endoscopic sleeve gastroplasty (ESG) has proven to be feasible, safe, and effective in the management of obesity. We performed the first systematic review and meta-analysis evaluating NAFLD and other metabolic parameters 12 months post-ESG. Four observational studies with a total of 175 patients were included. The results showed a significant (p < 0.05) reduction of 4.85 in hepatic steatosis index (95% CI - 6.02, - 3.67), 0.5 in NAFLD fibrosis score (95% CI - 0.80, - 0.19), 6.32 U/l in ALT (95% CI - 9.52, - 3.11), 17.28% in TWL (95% CI - 18.24, - 16.31), 6.31 kg/m(2) in BMI (95% CI - 8.11, - 4.52), 47.97% in EWL (95% CI - 49.10, - 46.84), and 0.51% in HbA1c (95% CI - 0.90, - 0.12). ESG improves liver parameters, provides weight loss, and reduces HbA1c levels in patients suffering from NAFLD.
conferenceObject HOT VERSUS COLD SNARE FOR COLORECTAL POLYPECTOMIES SIZED UP TO 10MM. A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) CAVASSOLA, Paulo; HIRSCH, Bruno Salomao; BESTETTI, Alexandre; OLIVEIRA, Guilherme Henrique Peixoto de; GOMES, Romulo; VERAS, Matheus; BERNARDO, Wanderley; MOURA, Diogo De; MOURA, Eduardo 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.