{"id":11053,"date":"2022-03-11T07:00:43","date_gmt":"2022-03-11T07:00:43","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/?p=11053"},"modified":"2022-07-12T17:14:27","modified_gmt":"2022-07-12T17:14:27","slug":"gastroparesia-e-o-endoscopista-com-isso","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/","title":{"rendered":"Gastroparesia"},"content":{"rendered":"

A gastroparesia \u00e9 uma desordem motora caracterizada clinicamente por saciedade precoce, distens\u00e3o abdominal, n\u00e1usea, regurgita\u00e7\u00e3o e v\u00f4mito. Seu diagn\u00f3stico costuma ser dado por sintomas t\u00edpicos e confirmado por cintilografia do esvaziamento g\u00e1strico.<\/p>\n

Existem alguns escores para mensurar o impacto cl\u00ednico da gastroparesia. O mais validado \u00e9 o Gastroparesis Cardinal Symptom Index (GCSI). Uma somat\u00f3ria maior ou igual a 20 \u00e9 indicativa de sintomas importantes com s\u00e9rio comprometimento da qualidade de vida (tabela 1).<\/p>\n

\"\"

Tabela 1<\/p><\/div>\n

PATOG\u00caNESE<\/strong><\/h2>\n

A patog\u00eanese do retardo do esvaziamento g\u00e1strico ainda n\u00e3o \u00e9 inteiramente compreendida, mas possui dois pilares: a hipomotilidade g\u00e1strica e o aumento da press\u00e3o pil\u00f3rica sem evid\u00eancia de obstru\u00e7\u00e3o mec\u00e2nica.<\/p>\n

As causas mais frequentes s\u00e3o a diabetes mellitus e a les\u00e3o cir\u00fargica do nervo vago. Outras etiologias como doen\u00e7as de dep\u00f3sito, neurol\u00f3gicas e infecciosas tamb\u00e9m podem estar relacionadas.<\/p>\n

 <\/p>\n

MANEJO<\/strong><\/h2>\n

Cl\u00ednico<\/h3>\n

O manejo cl\u00ednico \u00e9 baseado no controle glic\u00eamico associado a agentes procin\u00e9ticos, antiem\u00e9ticos e analg\u00e9sicos. Contudo, esta abordagem possui efic\u00e1cia limitada e efeitos colaterais indesej\u00e1veis(2).<\/p>\n

Cir\u00fargico<\/h3>\n

Nos pacientes refrat\u00e1rios ao tratamento cl\u00ednico, a piloroplastia \u00e9 uma op\u00e7\u00e3o terap\u00eautica eficaz. O racional de atuar sobre o piloro foi clinicamente comprovado em estudo envolvendo 177 pacientes submetidos a piloroplastia laparosc\u00f3pica. O seguimento por cinco anos identificou a normaliza\u00e7\u00e3o da cintilografia de esvaziamento g\u00e1strico em 77% dos pacientes. Apesar dos bons resultados, h\u00e1 um risco cir\u00fargico relevante de eventos adversos como vazamento, sangramento e infec\u00e7\u00e3o de ferida operat\u00f3ria(3).<\/p>\n

Endosc\u00f3pico<\/h3>\n

Abordagens endosc\u00f3picas como gastrostomia descompressiva, gastrojejunostomia (Figura 1), inje\u00e7\u00e3o pil\u00f3rica de toxina botul\u00ednica e at\u00e9 coloca\u00e7\u00e3o de stent transpil\u00f3rico s\u00e3o alternativas com efic\u00e1cia. Contudo os resultados ainda s\u00e3o insatisfat\u00f3rios e a evid\u00eancia \u00e9 limitada(4).<\/p>\n

\"\"

Figura 1 : PEG- jejuno<\/p><\/div>\n

G-POEM<\/em><\/h4>\n

Com a escalada da endoscopia do terceiro espa\u00e7o<\/a> , Kashab transportou o racional da piloroplastia cir\u00fargica para a esfera da endoscopia terap\u00eautica, realizando a primeira piloromiotomia endosc\u00f3pica (genericamente chamada de G-POEM) em 2013(5). A t\u00e9cnica vem ganhando espa\u00e7o na literatura com seus baix\u00edssimos \u00edndices de complica\u00e7\u00e3o e resultados cl\u00ednicos similares \u00e0 piloroplastia videolaparosc\u00f3pica(6).<\/p>\n

A t\u00e9cnica consiste em uma incis\u00e3o na mucosa do antro (mucosotomia) para acesso e confec\u00e7\u00e3o de um t\u00fanel submucoso rente \u00e0 muscular pr\u00f3pria at\u00e9 transpor o canal pil\u00f3rico. Ap\u00f3s a dissec\u00e7\u00e3o do esf\u00edncter, ele \u00e9 seccionado sob vis\u00e3o direta. Com esta interven\u00e7\u00e3o, observamos uma clara amplia\u00e7\u00e3o do canal pil\u00f3rico \u00e0 vis\u00e3o endosc\u00f3pica no antro. O tempo final do procedimento \u00e9 o fechamento da mucosotomia com clipes ou sutura endosc\u00f3pica(7).<\/p>\n

 <\/p>\n

\"\"

Figura 2: Piloro cerrado + inje\u00e7\u00e3o submucosa no trajeto do t\u00fanel<\/p><\/div>\n

 <\/p>\n

\"\"

Figura 3: Cap afunilado para a confec\u00e7\u00e3o da mucosotomia<\/p><\/div>\n

 <\/p>\n

\"\"

Figura 4: T\u00fanel submucoso<\/p><\/div>\n

 <\/p>\n

\"\"

Figura 5: In\u00edcio da piloromiotomia<\/p><\/div>\n

 <\/p>\n

\"\"

Figura 6: Piloro inteiramente seccionado<\/p><\/div>\n

 <\/p>\n

\"\"

Figura 7: Piloro ampliado<\/p><\/div>\n

 <\/p>\n

Em metan\u00e1lise realizada em 2020, foram identificados mais de 7000 publica\u00e7\u00f5es sobre a piloromiotomia endosc\u00f3pica, dimensionando a popularidade do tema(Dra. Karime Lucas -ref 8). Visando a objetiva mensura\u00e7\u00e3o da efic\u00e1cia t\u00e9cnica, foram inclu\u00eddos apenas os trabalhos com documenta\u00e7\u00e3o do GCSI e da cintilografia antes e ap\u00f3s o procedimento, totalizando 281 pacientes. O levantamento identificou 100% de sucesso t\u00e9cnico e 71% de sucesso cl\u00ednico. Havendo uma maior taxa de sucesso nas etiologias p\u00f3s cir\u00fargicas e idiop\u00e1ticas. Uma pior resposta foi encontrada nos pacientes diab\u00e9ticos e nos portadores de GCSI muito elevados (superior a 30).<\/p>\n

Uma taxa de \u00eaxito mais modesta foi encontrada em estudo prospectivo multic\u00eantrico envolvendo 80 pacientes publicado em 2022(9). O sucesso cl\u00ednico, definido como queda \u226525% em duas subescalas do escore GCSI, foi de 56% em 12 meses. Um n\u00famero inferior \u00e0 m\u00e9dia das publica\u00e7\u00f5es sobre o tema, ressaltando a necessidade de mais estudos para identificar o perfil de pacientes que obter\u00e3o melhores resultados com a piloromiotomia endosc\u00f3pica.<\/p>\n

CONCLUS\u00c3O<\/strong><\/h2>\n

A gastroparesia afeta de maneira marcante a qualidade de vida e o estado nutricional dos pacientes. A piloromiotomia endosc\u00f3pica (genericamente chamada de G-POEM) surgiu como uma alternativa promissora e segura no tratamento dos pacientes refrat\u00e1rios. Mais estudos prospectivos s\u00e3o necess\u00e1rios para confirmar os atuais resultados e individualizar o perfil de pacientes que mais se beneficiar\u00e3o da t\u00e9cnica.<\/p>\n

BIBLIOGRAFIA<\/strong><\/h2>\n

1. Cardinal G, Index S, Res QL, Pubmed N. Gastroparesis Cardinal Symptom Index ( GCSI ): development and validation of a patient reported assessment of severity of gastroparesis. 2013;11\u20132.<\/p>\n

2. Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. Clinical guideline: Management of gastroparesis. Am J Gastroenterol. 2013;108(1):18\u201337.<\/p>\n

3. Shada AL, Dunst CM, Pescarus R, Speer EA, Cassera M, Reavis KM, et al. Laparoscopic pyloroplasty is a safe and effective first-line surgical therapy for refractory gastroparesis. Surg Endosc. 2016;30(4):1326\u201332.<\/p>\n

4. Xu J, Chen T, Elkholy S, Xu M, Zhong Y, Zhang Y, et al. Gastric Peroral Endoscopic Myotomy (G-POEM) as a Treatment for Refractory Gastroparesis: Long-Term Outcomes. Can J Gastroenterol Hepatol. 2018;2018.<\/p>\n

5. Khashab MA, Stein E, Clarke JO, Saxena P, Kumbhari V, Chander Roland B, et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: First human endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2013;78(5):764\u20138.<\/p>\n

6. Landreneau JP, Strong AT, El-Hayek K, Tu C, Villamere J, Ponsky JL, et al. Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis. Surg Endosc [Internet]. 2019;33(3):773\u201381. Available from: http:\/\/dx.doi.org\/10.1007\/s00464-018-6342-6<\/p>\n

7. Li L, Spandorfer R, Qu C, Yang Y, Liang S, Chen H, et al. Gastric per-oral endoscopic myotomy for refractory gastroparesis: a detailed description of the procedure, our experience, and review of the literature. Surg Endosc [Internet]. 2018;32(8):3421\u201331. Available from: http:\/\/dx.doi.org\/10.1007\/s00464-018-6112-5<\/p>\n

8. Uemura KL, Chaves D, Bernardo WM, Uemura RS, de Moura DTH, de Moura EGH. Peroral endoscopic pyloromyotomy for gastroparesis: a systematic review and meta-analysis. Endosc Int Open. 2020;08(07):E911\u201323.<\/p>\n

9. Vosoughi K, Ichkhanian Y, Benias P, Miller L, Aadam AA, Triggs JR, et al. Gastric per-oral endoscopic myotomy (G-POEM) for refractory gastroparesis: Results from an international prospective trial. Gut. 2022;71(1):25\u201333.<\/p>\n","protected":false},"excerpt":{"rendered":"

A gastroparesia \u00e9 uma desordem motora caracterizada clinicamente por saciedade precoce, distens\u00e3o abdominal, n\u00e1usea,…<\/p>\n","protected":false},"author":2695,"featured_media":11058,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[151],"tags":[323,322,324,321],"ano":[309],"tipo":[153],"volume":[263],"class_list":["post-11053","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assuntosgerais","tag-gastroparesia","tag-piloro","tag-piloromiotomia","tag-poem","ano-309","tipo-endoscopia-digestiva-alta","volume-volume-i"],"yoast_head":"\nGastroparesia • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gastroparesia\" \/>\n<meta property=\"og:description\" content=\"A gastroparesia \u00e9 uma desordem motora caracterizada clinicamente por saciedade precoce, distens\u00e3o abdominal, n\u00e1usea, regurgita\u00e7\u00e3o e v\u00f4mito. Seu\" \/>\n<meta property=\"og:url\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\" \/>\n<meta property=\"og:site_name\" content=\"Endoscopia Terapeutica\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/endoscopiaterapeutica\" \/>\n<meta property=\"article:published_time\" content=\"2022-03-11T07:00:43+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-07-12T17:14:27+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png\" \/>\n\t<meta property=\"og:image:width\" content=\"564\" \/>\n\t<meta property=\"og:image:height\" content=\"452\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Jo\u00e3o Paulo Pontual\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Jo\u00e3o Paulo Pontual\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\"},\"author\":{\"name\":\"Jo\u00e3o Paulo Pontual\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/e5523048ca803fafb793ed2094f0829c\"},\"headline\":\"Gastroparesia\",\"datePublished\":\"2022-03-11T07:00:43+00:00\",\"dateModified\":\"2022-07-12T17:14:27+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\"},\"wordCount\":1068,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#organization\"},\"image\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png\",\"keywords\":[\"GASTROPARESIA\",\"PILORO\",\"PILOROMIOTOMIA\",\"POEM\"],\"articleSection\":[\"Assuntos Gerais\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\",\"name\":\"Gastroparesia • Endoscopia Terapeutica\",\"isPartOf\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png\",\"datePublished\":\"2022-03-11T07:00:43+00:00\",\"dateModified\":\"2022-07-12T17:14:27+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png\",\"contentUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png\",\"width\":564,\"height\":452,\"caption\":\"Figura 6: Piloro inteiramente seccionado\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/endoscopiaterapeutica.net\/pt\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Gastroparesia\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#website\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/\",\"name\":\"Endoscopia Terapeutica\",\"description\":\"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.\",\"publisher\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/endoscopiaterapeutica.net\/pt\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#organization\",\"name\":\"Endoscopia Terapeutica\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg\",\"contentUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg\",\"width\":720,\"height\":721,\"caption\":\"Endoscopia Terapeutica\"},\"image\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/endoscopiaterapeutica\",\"https:\/\/www.instagram.com\/endoscopy\/\",\"https:\/\/www.youtube.com\/@endoscopyonline\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/e5523048ca803fafb793ed2094f0829c\",\"name\":\"Jo\u00e3o Paulo Pontual\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/secure.gravatar.com\/avatar\/4bde018435f38ce9d6904061235db0430b5bbf4a3230b86aa72d1afe8097665a?s=96&d=mm&r=g\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/4bde018435f38ce9d6904061235db0430b5bbf4a3230b86aa72d1afe8097665a?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/4bde018435f38ce9d6904061235db0430b5bbf4a3230b86aa72d1afe8097665a?s=96&d=mm&r=g\",\"caption\":\"Jo\u00e3o Paulo Pontual\"},\"description\":\"Membro Titular da Sociedade Brasileira de Endoscopia Coordenador do Servi\u00e7o de Endoscopia Digestiva do Hospital das Cl\u00ednicas \u2013 UFPE Coordenador do Servi\u00e7o de Endoscopia do Centro Hospitalae UNIMED Recife M\u00e9dico endoscopista do Hospital D'Or Esperan\u00e7a\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/author\/jppontual\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Gastroparesia • Endoscopia Terapeutica","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/","og_locale":"pt_BR","og_type":"article","og_title":"Gastroparesia","og_description":"A gastroparesia \u00e9 uma desordem motora caracterizada clinicamente por saciedade precoce, distens\u00e3o abdominal, n\u00e1usea, regurgita\u00e7\u00e3o e v\u00f4mito. Seu","og_url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/","og_site_name":"Endoscopia Terapeutica","article_publisher":"https:\/\/www.facebook.com\/endoscopiaterapeutica","article_published_time":"2022-03-11T07:00:43+00:00","article_modified_time":"2022-07-12T17:14:27+00:00","og_image":[{"width":564,"height":452,"url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png","type":"image\/png"}],"author":"Jo\u00e3o Paulo Pontual","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Jo\u00e3o Paulo Pontual","Est. tempo de leitura":"7 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#article","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/"},"author":{"name":"Jo\u00e3o Paulo Pontual","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/e5523048ca803fafb793ed2094f0829c"},"headline":"Gastroparesia","datePublished":"2022-03-11T07:00:43+00:00","dateModified":"2022-07-12T17:14:27+00:00","mainEntityOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/"},"wordCount":1068,"commentCount":0,"publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png","keywords":["GASTROPARESIA","PILORO","PILOROMIOTOMIA","POEM"],"articleSection":["Assuntos Gerais"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/","name":"Gastroparesia • Endoscopia Terapeutica","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png","datePublished":"2022-03-11T07:00:43+00:00","dateModified":"2022-07-12T17:14:27+00:00","breadcrumb":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#primaryimage","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/03\/fig6.png","width":564,"height":452,"caption":"Figura 6: Piloro inteiramente seccionado"},{"@type":"BreadcrumbList","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/gastroparesia-e-o-endoscopista-com-isso\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/endoscopiaterapeutica.net\/pt\/"},{"@type":"ListItem","position":2,"name":"Gastroparesia"}]},{"@type":"WebSite","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","name":"Endoscopia Terapeutica","description":"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.","publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/endoscopiaterapeutica.net\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Organization","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization","name":"Endoscopia Terapeutica","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","logo":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","width":720,"height":721,"caption":"Endoscopia Terapeutica"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/endoscopiaterapeutica","https:\/\/www.instagram.com\/endoscopy\/","https:\/\/www.youtube.com\/@endoscopyonline"]},{"@type":"Person","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/e5523048ca803fafb793ed2094f0829c","name":"Jo\u00e3o Paulo Pontual","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/secure.gravatar.com\/avatar\/4bde018435f38ce9d6904061235db0430b5bbf4a3230b86aa72d1afe8097665a?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/4bde018435f38ce9d6904061235db0430b5bbf4a3230b86aa72d1afe8097665a?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/4bde018435f38ce9d6904061235db0430b5bbf4a3230b86aa72d1afe8097665a?s=96&d=mm&r=g","caption":"Jo\u00e3o Paulo Pontual"},"description":"Membro Titular da Sociedade Brasileira de Endoscopia Coordenador do Servi\u00e7o de Endoscopia Digestiva do Hospital das Cl\u00ednicas \u2013 UFPE Coordenador do Servi\u00e7o de Endoscopia do Centro Hospitalae UNIMED Recife M\u00e9dico endoscopista do Hospital D'Or Esperan\u00e7a","url":"https:\/\/endoscopiaterapeutica.net\/pt\/author\/jppontual\/"}]}},"_links":{"self":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/11053","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/users\/2695"}],"replies":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/comments?post=11053"}],"version-history":[{"count":8,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/11053\/revisions"}],"predecessor-version":[{"id":11724,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/11053\/revisions\/11724"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media\/11058"}],"wp:attachment":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media?parent=11053"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/categories?post=11053"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tags?post=11053"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/ano?post=11053"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tipo?post=11053"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/volume?post=11053"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}