Cirurgia oncológica de grande porte reduz a função muscular de pacientes com e sem risco nutricional

Abstract

To investigate the impact of oncological surgical procedures on the muscle function of patients with and without nutritional risk. Methods: Cross-sectional study conducted with cancer patients candidates for major operations between July 2018 to March 2019 in Cuiabá, Mato Grosso, Brazil. Patients were assessed preoperatively for nutritional risk by Nutritional Risk Screening-2002 and handgrip strength (FPP) was assessed both on the pre- and 2nd and 5th postoperative days (PO). Results: 92 patients were evaluated, of which 55.4% (N= 51) were men and 44.6% (N=41) women, with a mean age (SD) of 64 years (10.81) for patients at risk and 51 years (12.99) for patients without nutritional risk. The preoperative nutritional assessment showed that 34.8% of the patients had no risk and 65.2% had a nutritional risk. The FPP was lower (p = 0.008) in the group with nutritional risk (29,8Kgf vs. 31,7Kgf) in the preoperative period. In both groups, there was a significant drop in FPP on the 2nd PO day. The drop in FPP from the preoperative period (31,7Kgf) to the 2nd PO day (21,6Kgf) was more pronounced in patients without nutritional risk (p = 0.039). Patients with nutritional risk had a longer hospital stay (p = 0.049). Conclusion: Surgical trauma causes loss of muscle function in early PO. Patients without nutritional risk have a more significant decrease in muscle strength after surgical oncological procedures than those with nutritional risk. These results serve as a very strong argument for the implementation of pre-habilitation in all patients who are candidates for major oncological surgeries.