GUILHERME HENRIQUE PEIXOTO DE OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- 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.
- Endoscopic Treatment of Complex Walled-Off Necrosis in Necrotizing Pancreatitis With Two Simultaneous Lumen-Apposing Metal Stents: A Case Report(2022) SANTOS, Marcos Eduardo Lera dos; PROENCA, Igor Mendonca; SASSO, Joao Guilherme Ribeiro Jordao; OLIVEIRA, Victor Lira de; RIBAS, Pedro Henrique Boraschi Vieira; BESTETTI, Alexandre Moraes; RIBEIRO, Igor Braga; ANNA, Raoni Salomao Sant; OLIVEIRA, Guilherme Henrique Peixoto de; MOURA, Eduardo Guimaraes Hourneaux deOrganized pancreatic and peripancreatic collections are complications of pancreatitis and should be treated when symptomatic or complicated. When feasible, the endoscopic ultrasound approach presents high efficacy and low morbidity and mortality, making it the first likely option. Among the available accessories for endoscopic drainage, the lumen-apposing metal stent can be a better option, with a low migration rate; furthermore, it allows endoscopic necrosectomy. Here, we present the case of complex walled-off necrosis treated with two lumen-apposing metal stents in the same procedure. A 41-year-old male patient with walled-off necrosis presented with delayed gastric emptying and obstruction of the main biliary duct. Magnetic resonance imaging and endoscopic ultrasound revealed two non-communicating collections. We opted for endoscopic ultrasound-guided drainage with the deployment of two simultaneous lumen-apposing metal stents: one transduodenal and the other transgastric, with clinical improvement. After three weeks, endoscopic retrograde cholangiopancreatography showed a biliary fistula communicating with the periduodenal collection, which was treated with a biliary plastic stent. An endoscopic necrosectomy was performed, and the metal stents were removed. Control magnetic resonance imaging demonstrated improvement. The patient was asymptomatic at the six-month follow-up. The treatment of symptomatic complex walled-off necrosis remains a challenge and may require multiple endoscopic approaches; moreover, surgical treatment may be necessary in case of failure. In the present report, we demonstrate that the deployment of two lumen-apposing metal stents in the same procedure is feasible when necessary as it was associated with technical success and short-term clinical success.
- Endoscopic treatment of gastric antral vascular ectasia(2022) HIRSCH, Bruno Salomao; RIBEIRO, Igor Braga; FUNARI, Mateus Pereira; SAGAE, Vitor Massaro Takamatsu; MANCINI, Fabio Catache; OLIVEIRA, Guilherme Henrique Peixoto de; MOURA, Eduardo Guimaraes Hourneaux de; BERNARDO, Wanderley MarquesThe Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field, to standardize how to conduct, and to assist in the reasoning and decision-making of doctors. The information provided by this project must be critically evaluated by the physician responsible for the conduct that will be adopted depending on the conditions and the clinical condition of each patient.
- 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.
- Endoscopic Ultrasound View of Pneumatosis Cystoides Intestinalis(2023) YVAMOTO, Erika Yuki; CHENG, Spencer; OLIVEIRA, Guilherme Henrique Peixoto de; SASSO, Joao Guilherme Ribeiro Jordao; BOGHOSSIAN, Mateus Bond; MINATA, Mauricio Kazuyoshi; RIBEIRO, Igor Braga; MOURA, Eduardo Guimaraes Hourneaux dePneumatosis cystoid intestinalis (PCI) is a rare condition, with a worldwide incidence of 0.3-1.2%. PCI is classified into primary (idiopathic) and secondary forms, with 15% and 85% of presentations, respectively. This pathology was associated with a wide variety of underlining etiologies to explain the abnormal accumulation of gas within the submucosa (69.9%), subserosa (25.5%), or both layers (4.6%). Many patients endure misdiagnosis, mistreatment, or even inadequate surgical exploration. In this case, a patient presented acute diverticulitis, after treatment, a control colonoscopy was performed that found multiple rounds and elevated lesions. To further study the subepithelial lesion (SEL), a colorectal endoscopic ultrasound (EUS) was performed with an overtube in the same procedure. For safe insertion of the curvilinear array EUS, an overtube with colonoscopy was positioned through the sigmoid as described by Cheng et al. The EUS evaluation evidenced air reverberation in the submucosal layer. The pathological analysis was consistent with PCI's diagnosis. The diagnosis of PCI is usually made by colonoscopy (51.9%), surgery (40.6%), and radiological findings (10.9%). Although the diagnosis can be made by radiological studies, a colorectal EUS and colonoscopy can be made in the same section without radiation and with high precision. As it is a rare disease, there are not enough studies to define the best approach, although colorectal EUS should be preferred for a reliable diagnosis.
- 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.
- Effects of intragastric balloon placement in metabolic dysfunction-associated fatty liver disease: A systematic review and meta-analysis(2021) FREITAS JUNIOR, Joao Remi de; RIBEIRO, Igor Braga; MOURA, Diogo Turiani Hourneaux de; SAGAE, Vitor Massaro Takamatsu; SOUZA, Gabriel Mayo Vieira de; OLIVEIRA, Guilherme Henrique Peixoto de; SANCHEZ-LUNA, Sergio A.; SOUZA, Thiago Ferreira de; MOURA, Eduardo Turiani Hourneaux de; OLIVEIRA, Claudia Pinto Marques Souza de; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux deBACKGROUND Metabolic dysfunction-associated fatty liver disease corresponds to a clinical entity that affects liver function triggered by the accumulation of fat in the liver and is linked with metabolic dysregulation. AIM To evaluate the effects of the intragastric balloon (IGB) in patients with metabolic dysfunction-associated fatty liver disease through the assessment of liver enzymes, imaging and several metabolic markers. METHODS A comprehensive search was done of multiple electronic databases (MEDLINE, EMBASE, LILACS, Cochrane and Google Scholar) and grey literature from their inception until February 2021. Inclusion criteria involved patients with a body mass index > 25 kg/m(2) with evidence or previous diagnosis of hepatic steatosis. Outcomes analyzed before and after 6 mo of IGB removal were alanine aminotransferase (IU/L), gamma-glutamyltransferase (IU/L), glycated hemoglobin (%), triglycerides (mg/dL), systolic blood pressure (mmHg), homeostatic model assessment, abdominal circumference (cm), body mass index (kg/m(2)) and liver volume (cm(3)). RESULTS Ten retrospective cohort studies evaluating a total of 508 patients were included. After 6 mo of IGB placement, this significantly reduced alanine aminotransferase [mean difference (MD): 10.2, 95% confidence interval (CI): 8.12-12.3], gamma-glutamyltransferase (MD: 9.41, 95%CI: 6.94-11.88), glycated hemoglobin (MD: 0.17%, 95%CI: 0.03-0.31), triglycerides (MD: 38.58, 95%CI: 26.65-50.51), systolic pressure (MD: 7.27, 95%CI: 4.79-9.76), homeostatic model assessment (MD: 2.23%, 95%CI: 1.41-3.04), abdominal circumference (MD: 12.12, 95%CI: 9.82-14.41) and body mass index (MD: 5.07, 95%CI: 4.21-5.94). CONCLUSION IGB placement showed significant efficacy in improving alanine aminotransferase and gamma-glutamyltransferase levels in patients with metabolic dysfunction-associated fatty liver disease as well as improving metabolic markers related to disease progression.