Perfil nutricional de pacientes com câncer de esôfago submetidos à esofagectomia em um hospital da região central do sul do Brasil

Abstract

Individuals with esophageal cancer undergoing esophagectomy surgery are affected by several factors that lead to nutritional risk: unable to feed through the mouth due to obstruction of the esophageal channel, time between diagnosis and surgery, postoperative complications and the presence of clinical treatment before and/or after surgery. The objective of this study is to describe and analyze the nutritional profile of patients with esophageal cancer undergoing esophagectomy. This is a cross-sectional study involving 123 patients with esophageal cancer who underwent esophagectomy between 2008 and 2012 in a University Hospital in the central region of the south of the country. The data collection was performed by means of the medical records analysis. The analysis was performed through the EpiInfo version 7 program. Of the total surveyed, there was a ratio of 4 men for each woman, with a mean age of 59.3 ± 10.8 years. The majority (65.8%) of patients were in the advanced stage of the disease (III or IV), in which 44.7% had some surgical complication and 13% died. Only 2.9% showed no weight loss, while the rest ranged from no significant loss (14.3%), significant loss (5.7%) to severe weight loss (77.1%). While malnutrition was present in 31.4% of the patients, in the preoperative period malnourished patients were already 43.3%. After surgery, malnutrition reached 49% of patients and in the period after hospital discharge reached 53.8%. The patients received the first nutritional evaluation after the diagnosis of the disease, in a mean period of 55.9 ± 109.4 days. An association between elderly patients and malnutrition was found in all stages of the treatment, whether at diagnosis, preoperative, postoperative and within six months after surgery. Age over 60 years was also significantly associated with postoperative complications and death. In the present study, no association was found between weight loss and hypoalbuminemia with postoperative complications or with death. However, the patients’ hospitalization time was significantly associated with postoperative complications. Early nutritional assessment and monitoring of all patients during the pre- and post-surgical period of esophageal cancer patients should be part of the therapy to ensure adequate nutritional status in order to avoid undesirable outcomes during treatment and to provide quality of life.