MATEUS PEREIRA FUNARI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Managing adverse events after endoscopic ultrasound-guided drainage of the biliary tract and pancreatic fluid collections: Narrative review (with video)(2022) FUNARI, Mateus Pereira; RIBEIRO, Igor Braga; SANTOS, Marcos Eduardo Lera dos; MATUGUMA, Sergio Eiji; MOURA, Eduardo Guimaraes Hourneaux deEndoscopic ultrasound (EUS)-guided therapeutic procedures have become increasingly common in clinical practice. The development of EUS-guided fine needle aspiration cytology led to the concept of interventional EUS. However, it carries a considerable risk of adverse events (AEs), which occur in approximately 23% of the procedures performed for the drainage of pancreatic fluid collections and 2.5-37.0% of those performed for drainage of the biliary tract. Although the vast majority of AEs occurring after EUS-guided drainage are mild, a deep understanding of such events is necessary for their appropriate management. Because EUS-guided drainage is a novel procedure, there have been few studies of the topic. To our knowledge, this is the first narrative review that focuses on the management and resolution of AEs occurring after EUS-guided drainage of pancreatic fluid collections or the biliary tract. We also include an explanatory video.
- Endoscopic septotomy for fistula after bariatric surgery(2022) BOGHOSSIAN, Mateus Bond; FUNARI, Mateus Pereira; MONTE JUNIOR, Epifanio Silvino do; ROCHA, Rodrigo Silva de Paula; MOURA, Diogo Turiani Hourneaux de; SOUZA, Thiago Ferreira de; MOURA, Eduardo Guimaraes Hourneaux de
- Role of cholangioscopy and therapeutic options in complex anastomotic strictures after liver transplantation(2022) FUNARI, Mateus Pereira; HIRSCH, Bruno Salomao; FRANZINI, Tomazo Prince; MOURA, Diogo Turiani Hourneaux de; MIRANDA NETO, Antonio Afonso; MCCARTY, Thomas R.; MOURA, Eduardo Guimaraes Hourneaux de
- 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.
- Endoscopic biliary sphincterotomy: electric current mode(2022) FUNARI, Mateus Pereira; SAGAE, Vitor Massaro Takamatsu; MOURA, Eduardo Guimaraes Hourneaux de; BERNARDO, Wanderley MarquesINTRODUCTION Endoscopic retrograde cholangiopancreatography (ERCP) asso-ciated with biliary sphincterotomy is a procedure performed widely in medical practice. However, this intervention is not an exempt from complications (4-5%) such as acute pancreatitis, bleeding, perforation, cholangitis, or even death (0.02-0.4%)1-3. Several studies point to the correlation between the electric cur-rent mode (pure cut, blend, pulsed cut, or endocut, and pure cut followed by blend) used in endoscopic sphincterotomy and the inci-dence of adverse events4-6. A better knowledge of the subject based on evidence can assist us in making the best decision in clinical practice. Our objective is, through a systematic review and meta -anal-ysis, to trace the safety profile of each modality of electric cur-rent (pure cut, pulsed cut, blend cut, and pure cut followed by blend) employed in endoscopic biliary sphincterotomy to reduce the incidence of adverse events related to this procedure. METHODS A systematic review and meta-analysis of the literature (Medline, Central Cochrane, Embase, LILACS VHL, and grey litera-ture) were carried out according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) recommendations7. We used the PICO system (Patient: older than 18 years with the indication of ERCP and biliary sphinc-terotomy; Intervention and Control: respective modalities of electric current; and Outcome: adverse events such as acute pancreatitis, bleeding, perforation, and cholangitis). We selected only randomized controlled trials that included patients aged more than 18 years who underwent ERCP with biliary sphincterotomy for various causes (e.g., choledocholithiasis, obstructive neoplasia, benign strictures, and biliary fistulas) random-ized to any of the modalities of electric current under evaluation. The risk of bias in each study was assessed using the Cochrane bias risk tool8. The level of evidence for each outcome was eval-uated according to GRADE (Grading of Recommendations Assessment, Development and Evaluation)9. The data were meta-analyzed using the RevMan 5.3 soft-ware, and the results were revealed as forest plots. RESULTS After removing duplicates, 12,282 articles were screened, including 10 randomized clinical trials in our study4,10-18. Annex Figure 1 summarizes the selection process. The risk of bias in the included studies is expressed in Annex Table 1. The characteristics of the studies and results are presented in Chart 1. Results expressed by comparison:
- Use of an electromagnetic-guided device to assist with post-pyloric placement of a nasoenteral feeding tube: A systematic review and meta-analysis(2022) MANCINI, Fabio Catache; MOURA, Diogo Turiani Hourneaux de; FUNARI, Mateus Pereira; RIBEIRO, Igor Braga; NETO, Fernando Lopes Ponte; MENDIETA, Pastor Joaquin Ortiz; MCCARTY, Thomas R.; BERNARDO, Wanderley Marques; NAHAS, Sergio Carlos; MOURA, Eduardo Guimaraes Hourneaux deBackground and study aims While endoscopic-guided placement (EGP) of a post-pyloric nasoenteral feeding tube may improve caloric intake and reduce the risk of bronchoaspiration, an electromagnetic-guided placement (EMGP) method may obviate the need for endoscopic procedures. Therefore, the primary aim of this study was to perform a systematic review and meta-analysis of randomized trials comparing the efficacy and safety of EMGP versus EGP of a post-pyloric feeding tube. Methods Protocolized searches were performed from the inception through January 2021 following PRISMA guidelines. Only randomized controlled trials were included comparing EMGP versus EGP. Study outcomes included: technical success (defined as appropriate post-pyloric positioning), tube and patient associated adverse events (AEs), time to enteral nutrition, procedure-associated cost, and procedure time. Pooled risk difference (RD) and mean difference (MD) were calculated using a fixed-effects model and heterogeneity evaluated using Higgins test (I-2). Results Four randomized trials (n =536) were included. A total of 287 patients were included in the EMGP group and 249 patients in the EGP group. There was no difference between EMGP versus EGP regarding technical success, tube-related AEs, patient-related AEs, procedure time, and time in the right position. Time to enteral nutrition favored EMGP (MD: -134.37 [-162.13, -106.61]; 1 2 =35%); with significantly decreased associated cost (MD: -127.77 (5) [-135.8-119.73]; I-2 =0%). Conclusions Based on this study, EMGP and EGP were associated with similar levels of technical success and safety as well as time to complete the procedure. Despite this, EMGP was associated with reduced cost and time to initiation of nutrition.
- 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