VITOR OTTOBONI BRUNALDI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina

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Autor: BRUNALDI, Vitor O. × Revista / Livro: Obesity Surgery ×

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  • article 58 Citação(ões) na Scopus
    Efficacy and Safety of Stents in the Treatment of Fistula After Bariatric Surgery: a Systematic Review and Meta-analysis
    (2018) OKAZAKI, Ossamu; BERNARDO, Wanderley M.; BRUNALDI, Vitor O.; CLEMENTE JUNIOR, Cesar C. de; MINATA, Mauricio K.; MOURA, Diogo T. H. de; SOUZA, Thiago F. de; CAMPOS, Josemberg Marins; SANTO, Marco Aurelio; MOURA, Eduardo G. H. de
    Fistula development is a serious complication after bariatric surgery. We performed a systematic review and meta-analysis to assess the efficacy of fistula closure and complications associated with endoscopic stent treatment of fistulas, developed after bariatric surgeries, particularly Roux-en-Y gastric bypass (RYGB) and gastric sleeve (GS). Studies involving patients with fistula after RYGB or GS and those who received stent treatment only were selected. The analyzed outcomes were overall success rate of fistula closure, mean number of stents per patient, mean stent dwelling time, and procedure-associated complications. Current evidence from identified studies demonstrates that, in selected patients, endoscopic stent treatment of fistulas after GS or RYGB can be safe and effective.
  • article 1 Citação(ões) na Scopus
    Correlation Between Gastrojejunal Anastomosis Diameter, Distensibility Index, and Weight Regain After Roux-en-Y Gastric Bypass
    (2023) RAZZAK, Farah Abdul; KERBAGE, Anthony; BRUNALDI, Vitor O.; MRAD, Rudy; MAHMOUD, Tala; GALA, Khushboo; VARGAS, Eric J.; STORM, Andrew; GHANEM, Omar; DAYYEH, Barham Abu
    Introduction: Gastrojejunal anastomosis (GJA) dilation is an independent predictor of weight regain (WR) after Roux-en-Y gastric bypass (RYGB). However, the role of planimetric measurements in this context remains unknown.Methods: This is a retrospective cohort study including adult RYGB patients who underwent a diagnostic endoscopy with Endoflip assessment of the GJA. We excluded patients in the early postoperative period and those with abnormal endoscopic findings (marginal ulcers and gastro-gastric fistulas).Results: Thirty-four patients were initially included. Endoscopic GJA diameter had a moderate positive correlation with WR (r=+0.438, p=0.011). However, after excluding the 7 patients with GJA> 30 mm, there was no significant correlation. There was a moderate agreement between the EndoFLIP-GJA diameter at 60mL and endoscopic diameter (ICC=0.576, p=0.049). The distensibility index (DI) showed a consistent moderate negative correlation with WR. Considering the maximum DI at 40 ml, we found a cutoff of DI = 7 mm(2)/mmHg that split the sample in two significantly different populations in terms of WR (67.4% vs. 43.2%, p=0.04).Conclusion: Visual estimation of the GJA diameter correlates with EndoFLIP at 60mL. In the subset of patients with GJA <= 30 mm, more distensible GJAs are associated with lower rates of WR. Larger studies are needed to confirm this correlation and to validate its utility for clinical management.