Arquivos de Gastroenterologia最新文献

{"title":"THE DOUBLE BURDEN OF CIRRHOSIS AND ACUTE PANCREATITIS: AMPLIFIED RISKS FOR NUTRITIONAL AND GASTROINTESTINAL COMPLICATIONS.","authors":"Chidera N Onwuzo, Kikunlore Elijah Odunsanya, Fnu Alvina, Rashid Abdel Razeq, Kojo-Frimpong B Awuah, Somtochukwu Onwuzo","doi":"10.1590/S0004-2803.24612025105","DOIUrl":"10.1590/S0004-2803.24612025105","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis and acute pancreatitis (AP) are significant causes of morbidity and mortality, and their coexistence magnifies the risk of systemic complications. Patients with both conditions are particularly vulnerable to adverse outcomes, including gastrointestinal and nutritional challenges. This study examines the impact of cirrhosis on 1-year outcomes in AP patients, focusing on pseudocyst formation, protein-calorie malnutrition, ileus, small bowel obstruction, and the need for nutritional interventions such as total parenteral nutrition (TPN) or percutaneous endoscopic gastrostomy (PEG).</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using TriNetX database. Patients with AP were identified and divided into two cohorts: those with cirrhosis (Cohort 1) and those without cirrhosis (Cohort 2). Propensity score matching balanced baseline characteristics, resulting in 26,160 patients in each cohort. Outcomes were tracked over one year, including pseudocyst formation, ileus, small bowel obstruction, malnutrition, and nutritional interventions. Kaplan-Meier survival estimates and hazard ratios with 95% confidence intervals assessed risk differences between cohorts.</p><p><strong>Results: </strong>Cirrhosis significantly worsened outcomes compared to non-cirrhosis. Protein-calorie malnutrition was twice as common (P<0,001), affecting 5.2% of cirrhotic patients versus 2.6% of non-cirrhotic patients. Risks for ileus (P<0,001) and small bowel obstruction (P<0,001) were also significantly higher, with incidences of 2.7% and 1.7%, respectively, in cirrhotic patients. The need for TPN was more frequent in the cirrhosis cohort (P<0,001), affecting 1.9% compared to 1.2%. Conversely, pseudocyst formation was less frequent in cirrhotic patients (P=0,018), with an incidence of 2.3% versus 2.8%. PEG insertion and abdominal compartment syndrome showed no significant differences.</p><p><strong>Conclusion: </strong>Cirrhosis amplifies the risk of nutritional deficiencies, ileus, and small bowel obstruction in AP patients, emphasizing the need for proactive, multidisciplinary management strategies for this high-risk population. The reduced incidence of pseudocyst formation may reflect altered disease progression in cirrhosis.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25105"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THREE-MONTH OUTCOMES OF ISCHEMIC COLITIS IN ANOREXIC VS NON-ANOREXIC PATIENTS: A PROPENSITY-MATCHED COHORT STUDY.","authors":"Chidera Onwuzo, Fnu Alvina, Rashid Abdel-Razeq, Kofi Awuah, Somtochukwu Onwuzo","doi":"10.1590/S0004-2803.24612025-102","DOIUrl":"10.1590/S0004-2803.24612025-102","url":null,"abstract":"<p><strong>Background: </strong>Ischemic colitis arises from a reduction in mesenteric blood flow, a condition often aggravated by factors such as severe dieting observed in individuals with anorexia nervosa which compromise the gastrointestinal vasculature, increasing the susceptibility to ischemic injury. Objective: This study aims to rigorously compare three-month clinical outcomes, including colectomy rates, mortality, and other complications, between anorexic and non-anorexic patients diagnosed with ischemic colitis.</p><p><strong>Methods: </strong>A validated multicenter database of more than 70 different healthcare systems across the United States was utilized. The population was divided into, Cohort 1 that consisted of anorexic patients with ischemic colitis and Cohort 2 which consisted of non-anorexic patients with ischemic colitis. After propensity score matching, a total of 450 patients were identified in each cohort. Outcomes were assessed over a 90-day period following the index event of ischemic colitis diagnosis. Kaplan-Meier curves and risk analyses were conducted to evaluate mortality, parenteral nutrition requirement, PEG placement and colectomy rates.</p><p><strong>Results: </strong>At three months, anorexic patients demonstrated significantly higher colectomy rates odds ratio (OR) of 2.262 (95%CI: 1.269-4.031, P=0.005) and mortality with an OR of 1.462 (95%CI: 1.079-1.981, P=0.014) compared to their non-anorexic counterparts. The differences in PEG insertion and PN (parenteral nutrition) use were not statistically significant.</p><p><strong>Conclusion: </strong>Anorexic patients with ischemic colitis experience significantly worse short-term outcomes, including higher rates of mortality and colectomy, compared to their non-anorexic counterparts.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25102"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LONG-TERM QUALITY OF LIFE AFTER ILEAL POUCH-ANAL ANASTOMOSIS FOR ULCERATIVE COLITIS IN A BRAZILIAN IBD REFERRAL CENTER.","authors":"Israel Geraldo Silva, Sandro da Costa Ferreira, Omar Féres, Marley Ribeiro Feitosa, José Joaquim Ribeiro da Rocha, Rogério Serafim Parra","doi":"10.1590/S0004-2803.24612025-071","DOIUrl":"10.1590/S0004-2803.24612025-071","url":null,"abstract":"<p><strong>Background: </strong>Reports on the long-term impact on quality of life (QoL) after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) are scarce in Latin America.</p><p><strong>Objective: </strong>To evaluate QoL after IPAA in an inflammatory bowel disease (IBD) referral center in Brazil.</p><p><strong>Methods: </strong>From March 2023 to August 2023, a standardized questionnaire was administered to patients with UC who had previously undergone IPAA surgery. The questionnaire addressed: (1) daily bowel movement frequency, (2) daytime and nighttime fecal incontinence, (3) need for daily medication such as loperamide, (4) fecal urgency, (5) social limitations, (6) fatigue, (7) impact on sexual life, (8) use of diapers, and (9) impact on work ability.</p><p><strong>Results: </strong>In total, 28 patients completed the questionnaire. Most patients were female (19, 67.9%), with a mean age of 44.8±10.2 years and an average follow-up time of 13.8 years. Patients reported an average of 6.0±1.8 bowel movements per day, with 27 (96.4%) experiencing diarrhea. Diaper use was generally unnecessary (22, 78.6%). Most patients had nocturnal bowel movements (24, 85.7%) and fecal urgency (17, 60.7%). Antidiarrheal medication (loperamide) was required by 21 patients (75%) to reduce bowel movement frequency. Despite high satisfaction levels with IPAA (22, 78.6%), patients reported negative impacts on bowel habits and several QoL domains, including fatigue (27, 96.4%), sexual life (18, 64.3%), social and work activities (22, 78.6%), and feelings of shame (21, 75%). However, dietary restrictions were minimal (17, 60.7%).</p><p><strong>Conclusion: </strong>Although long-term satisfaction with IPAA is high, patients experience significant negative impacts on bowel habits and QoL. These findings underscore the need for targeted strategies to improve outcomes and support for future IPAA patients.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25071"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AEROBIC EXERCISE ATTENUATES HEPATIC LIPID PEROXIDATION IN AN EXPERIMENTAL MODEL OF OBESITY-ASSOCIATED NAFLD.","authors":"Maria Luiza Rodrigues Pereira Lima, Carolina Rosa Gioda, Laura Hora Rios Leite, Cândido Celso Coimbra, Bernardo Henrique Mendes Correa, Virginia Hora Rios Leite, Teresa Cristina Abreu Ferrari","doi":"10.1590/S0004-2803.24612025-086","DOIUrl":"10.1590/S0004-2803.24612025-086","url":null,"abstract":"<p><strong>Background: </strong>The global rise in obesity has been accompanied by an increasing prevalence of nonalcoholic fatty liver disease (NAFLD), for which effective non-pharmacological therapeutic strategies remain limited.</p><p><strong>Objective: </strong>This study investigated the effects of aerobic exercise on hepatic oxidative stress in an experimental model of obesity-associated NAFLD.</p><p><strong>Methods: </strong>Newly weaned Wistar rats were fed a highly palatable, obesity-inducing diet. After obesity was established, the animals were randomly assigned to either a trained group (n=12) or a sedentary group (n=12). The trained group underwent moderate-intensity treadmill running for eight weeks. Hepatic lipid peroxidation was assessed using the TBARS (thiobarbituric acid reactive substances) assay.</p><p><strong>Results: </strong>Aerobic training significantly reduced hepatic TBARS levels (P<0.0005), in an average of 1.8 nmol MDA/mg protein compared to the sedentary group. These benefits were significant regardless of weight gain maintenance.</p><p><strong>Conclusion: </strong>The findings suggest that regular physical exercise attenuates hepatic lipid peroxidation in an experimental model of obesity-associated NAFLD. The results support that physical exercise is an effective non-pharmacological strategy for modulating oxidative stress and preventing disease progression.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25086"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ROLE OF STATINS IN CIRRHOTIC PORTAL HYPERTENSION: META-ANALYSIS OF RANDOMIZED STUDIES.","authors":"Mariana Oliveira Amarante Moreno, Cláudio Luiz da Silva Lima Paz, Mariana Alves Nascimento Rodrigues, Antonio Carlos Dias Andrade, Maria Gabriela Fernandes Dezan, Lourianne Nascimento Cavalcante, André Castro Lyra","doi":"10.1590/S0004-2803.24612025-036","DOIUrl":"10.1590/S0004-2803.24612025-036","url":null,"abstract":"<p><strong>Background: </strong>Physicians often use caution when prescribing statins to patients with chronic liver disease (CLD) due to potential hepatotoxicity. However, recent evidence indicates that hepatotoxicity is uncommon, and the risks of not using statins may often outweigh those associated with their use. Additionally, recent findings suggest that statins may have clinically beneficial effects on cirrhosis due to their pleiotropic properties.</p><p><strong>Objective: </strong>To evaluate the impact of statin use on the number of patients with chronic liver disease alive at the end of the trials and to assess its effects on portal hypertension, ascites, hepatic encephalopathy, variceal hemorrhage, and hepatocellular carcinoma.</p><p><strong>Methods: </strong>This meta-analysis analyzed 9 randomized clinical trials published in the MEDLINE, EMBASE, and SCOPUS databases that evaluated the use of statins in patients with cirrhosis. These studies included a total of 811 subjects with portal hypertension, of which 401 patients were in the intervention group. We assessed risk of bias using the Risk of Bias 2 (RoB 2) tool for randomized clinical trials, and we analyzed the quality of evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) scale. We extracted data on the number of events and the total number of patients to perform a meta-analysis of proportions using the R software with the \"meta\" package (version 4.9-6).</p><p><strong>Results: </strong>Our meta-analysis on patients alive at the end of the trials included 5 studies, involving a total of 718 patients (352 in the statin group and 366 in the control group). From these, 618 patients were alive at the end of the studies, with 301 from the intervention group and 287 from the control group. The overall odds ratio (OR) between the groups was 1.79 (95%CI -1.04 to 3.06; I²: 20.3%), favoring the use of statins. The results for variceal gastrointestinal bleeding showed an OR of 0.67 (95%CI, 0.41 to 1.09; I²: 0%); for hemodynamic response, the OR was 2.41 (95%CI, 0.65 to 8.92; I²: 66%); for hepatic encephalopathy, the OR was 0.41 (95%CI, 0.06 to 2.77; I²: 61%); for myalgia, an OR of 0.74 (95%CI, 0.22 to 2.46; I²: 1%); and for ascites, the OR was 0.84 (95%CI, 0.48 to 1.48; I²: 0%).</p><p><strong>Conclusion: </strong>The use of statins is associated with a greater number of patients with hepatic cirrhosis alive at the end of the trials. However, we were unable to determine the reason for this potential beneficial effect.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25036"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INNOVATION AND SUSTAINABILITY IN PATIENT CARE IN THE ERA OF HEALTH RESOURCE MOBILIZATION.","authors":"Everson Luiz de Almeida Artifon, Alberto Terrivel, Marcio Roberto Facanali Junior","doi":"10.1590/S0004-2803.24612025-E02","DOIUrl":"10.1590/S0004-2803.24612025-E02","url":null,"abstract":"","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25E02"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UTILITY OF THE REOPENABLE CLIP-OVER-THE-LINE METHOD FOR DEFECT CLOSURE AFTER ENDOSCOPIC INTERMUSCULAR DISSECTION OF RECTAL DEEP SUBMUCOSAL INVASIVE CANCER.","authors":"Taiji Yoshimoto, Hiroo Ishii, Hiroshi Takihara","doi":"10.1590/S0004-2803.24612025-116","DOIUrl":"10.1590/S0004-2803.24612025-116","url":null,"abstract":"","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25116"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRENDS IN THE CLINICALPRESENTATION OF CELIAC DISEASE IN BRAZILIAN ADULTS SEEN IN THE LAST 50 YEARS IN A PRIVATE OFFICE.","authors":"Lorete Maria da Silva Kotze, Shirley Ramos da Rosa Utiyama, Luiz Roberto Kotze, Fabiana Antunes Andrade, Renato Nisihara","doi":"10.1590/S0004-2803.24612025-118","DOIUrl":"10.1590/S0004-2803.24612025-118","url":null,"abstract":"<p><strong>Background: </strong>Since the mid-20th century, celiac disease (CD) has evolved from being regarded as a predominantly pediatric disorder to one increasingly recognized across all ages. In Brazil, CD was initially underdiagnosed, but diagnostic advances and greater awareness have led to a broader understanding of its epidemiology and clinical spectrum.</p><p><strong>Objective: </strong>To describe the evolving clinical, laboratory, and histological profile of Brazilian adults diagnosed with CD over the past five decades.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted including 181 adults with biopsy-confirmed CD managed at a referral private practice in in Curitiba, Brazil, from 1975 to 2025. Patients were stratified into three diagnostic phases: phase 1 (1975-2000), phase 2 (2001-2010), and phase 3 (2011-2025). Clinical manifestations, nutritional status, comorbidities, histological findings, and laboratory parameters were analyzed comparatively.</p><p><strong>Results: </strong>The cohort was predominantly female (84.8%), with a median age of 36 years at diagnosis. Marsh III lesions were observed in 98.0% of phase 1 cases, remaining the most frequent finding across phases. Underweight was prevalent in phase 1 (63.2%) but declined significantly in phase 2 (26.4%) and phase 3 (16.5%), reflecting, probably, earlier detection. Diarrhea predominated in phases 1 and 2, whereas constipation became more frequent in phase 3. Extraintestinal manifestations such as anemia, fatigue, and weight loss decreased over time, while reports of comorbid immune-mediated diseases and family history of gluten-related disorders increased.</p><p><strong>Conclusion: </strong>Over the last 50 years, the clinical presentation of CD in Southern Brazil has shifted from advanced malnourished states with diarrhea to more heterogeneous profiles including constipation and overweight. Despite advances in serology, duodenal biopsy remains the gold standard for diagnosis. These findings underscore the importance of continuous clinical vigilance and reflect a sustained contribution to CD management in Brazil.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25118"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPLORING THE IMPACT OF GUT MICROBIOTA MODULATION ON COLORECTAL CANCER THERAPY: A BIBLIOMETRIC ANALYSIS OF PROBIOTIC AND PREBIOTIC INTERVENTIONS.","authors":"Elisha Apatewen Akanbong, Ali Şenol, Özkan Duru, Erva Eser, Haceli Öcal, Miyase Çinar","doi":"10.1590/S0004-2803.24612025-087","DOIUrl":"10.1590/S0004-2803.24612025-087","url":null,"abstract":"<p><strong>Objective: </strong>This study is a bibliometric analysis of scientific publications reporting the beneficial effects of gut microbiota modulation by probiotics and/or prebiotics on colorectal cancer.</p><p><strong>Methods: </strong>This study adhered to the PRISMA guidelines and focused on English peer-reviewed research articles published between 2020 and 2025, as indexed in Google Scholar and PubMed. Search terms included \"Colorectal Cancer\", \"Colon Cancer\", \"Colorectal Carcinoma\", \"Colon Carcinoma\" and \"Gut Microbiota\". A total of 116 studies were selected and manually reviewed, taking into account the inclusion and exclusion criteria.</p><p><strong>Results: </strong>The bibliometric analysis of 37 studies revealed that China leads research efforts, primarily focusing on prebiotics (70.3%), such as dietary fibres, while probiotic-focused studies are limited (24.3%) due to practical challenges. Although the combined use of prebiotics and probiotics (2.7%) is theoretically beneficial, their practical application remains complicated. The trend in the literature aligns with a growing interest in traditional medicine and functional foods, but annual publication rates have declined, with only three papers from 2025 (30.8%). Despite recognising microbial diversity, the number of probiotic-based studies is low, with Clostridium butyricum being the most prevalent species.</p><p><strong>Conclusion: </strong>Overall, this analysis underscores the critical role of gut microbiota in CRC treatment and the potential of natural compounds, while highlighting the need for further research. Further research is essential to deepen our understanding of gut microbiota dynamics and optimise therapeutic approaches for patients with CRC.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25087"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTIVENESS OF LIGAMENTUM TERES CARDIOPEXY FOR GERD RESOLUTION AFTER SLEEVE GASTRECTOMY: A META-ANALYSIS AND SYSTEMATIC REVIEW.","authors":"Pedro Bicudo Bregion, Victor Kenzo Ivano, Luca Maunsell Pereira, Isadora Chrispim, Everton Cazzo, Anna Carolina Batista Dantas","doi":"10.1590/S0004-2803.24612025-080","DOIUrl":"10.1590/S0004-2803.24612025-080","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal Reflux Disease (GERD) is the most common long-term complication after Sleeve Gastrectomy (SG). Ligamentum teres cardiopexy (LTC) has been proposed as a revisional alternative to treat GERD symptoms.</p><p><strong>Objective: </strong>To evaluate, through a systematic review and meta-analysis, the safety and effectiveness of LTC in the remission of GERD symptoms and in reducing the use of anti-reflux medications in patients who previously underwent SG.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis to evaluate LTC's safety and its impact on GERD after SG. We systematically searched PubMed, EMBASE, and Cochrane Central for studies assessing LTC in patients who underwent SG up to april 2025. The primary outcomes included remission of GERD symptoms and prevalence of GERD medications after surgery. Secondary outcomes were length of stay and adverse effects. Observational studies were included. A random-effects model analysis for GERD remission and prevalence of GERD medications were performed. Study weights were calculated using the inverse variance method, with statistical analyses conducted in R version 4.4.0.</p><p><strong>Results: </strong>Four studies including 193 patients were analyzed. Overall, remission of GERD symptoms among patients undergoing revisional LTC alone, the remission rate was 75.50% (95%CI 59.55-86.57; I²=41.4%). Additionally, 33.42% of patients (95%CI 19.74-50.60; I²=44.7%) needed to use GERD-related medication postoperatively.</p><p><strong>Conclusion: </strong>LTC shows potential as a surgical option for managing GERD after SG, particularly in revisional cases as an alternative to Roux-en-Y gastric bypass.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25080"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}