Risco nutricional de pacientes submetidos à cirurgia eletiva de câncer colorretal

Abstract

Introduction: Involuntary weight loss is a nutritional disorder frequently observed in cancer patients and is associated with higher rates of postoperative morbidity and mortality. The patient's nutritional status directly influences the prognosis and response to surgical treatment, justifying the relevance of perioperative nutritional assessment and interventions. Objective: To assess the nutritional risk of patients undergoing elective colorectal surgery in the preoperative and postoperative periods. Method: Quantitative before-and-after study, carried out in the gastrosurgery inpatient unit of a large hospital in the interior of São Paulo. The sample was a convenience sample, part of a larger randomized clinical trial, composed of 25 participants aged > 18 years, who underwent elective colorectal surgeries from august 2023 to august 2024. The nutritional assessment of patients occurred in two stages, at hospital admission and discharge, consisting of the application of the Patient-Generated Subjective Global Assessment (PG-SGA) instrument; collection of biochemical tests and execution of anthropometric assessment. Data collection was performed using a tablet, with information recorded on the RedCap platform, and analyses were performed using descriptive and inferential statistics. Results: There was an increase in the mean ASG-PPP score, from 11.44 (SD = 7.23) at admission to 17.16 (SD = 5.69) at discharge; the number of patients in category B of moderate malnutrition increased from 4 (16%) at admission to 12 (48%) at discharge; 5 (20%) of the participants arrived at admission with a weight loss in the last month considered significant or severe; the adequacy of the AMBc in 80% of the participants was below adequate at admission. Regarding biochemical tests, we found in the preoperative period, 10 (40%) of the sample with transferrin saturation below the reference value; 4 (16%) with hypoalbuminemia and 8 (32%) with anemia. A positive correlation was observed with a higher PPP-SGA score at discharge and the occurrence of some type of complication during hospitalization. Conclusion: The perioperative period has been shown to be a time that increases the nutritional risk of patients with colorectal cancer, especially in the postoperative period. The preoperative period is an opportune window for performing nutritional screening and interventions that can optimize preparation for surgery and recovery of surgical oncology patients.