Abstract
to investigate the impact of oncological surgical procedures on the muscle function of patients with and without nutritional risk. cross-sectional study conducted with cancer patients undergoing major operations between July 2018 to March 2019 in Cuiabá, Mato Grosso, Brazil. Patients were assessed preoperatively for the nutritional risk by the Nutricional Risk Screening-2002, and handgrip strength (FPP) was assessed both on the pre- and 2nd and 5th postoperative days (PO). 92 patients were evaluated, of whom 55.4% were men and 44.6% women, with a mean age (SD) of 64 (10.81) for patients at risk and 51 (12.99) for patients without nutritional risk. The preoperative nutritional risk evaluation indicated 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 in the preoperative period. In both groups, there was a significant drop in FPP on the 2nd PO day. The preoperative FPP compared with the 2nd PO FPP was more pronounced in patients without nutritional risk (p = 0.039). Patients with nutritional risk had a longer hospital stay (p = 0.049). surgical trauma causes loss of muscle function in the 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 may infer the need to implement pre-habilitation in all patients who will undergo major oncological procedures.
Highlights
Cancer is a disease that compromises the nutritional status, leading to morphological, functional, and metabolic changes
Nutritional status before surgery and how it is affected by the surgical trauma are determinant factors regarding postoperative loss of muscle mass and functional capacity[1]
Patients without nutritional risk suffered a more significant decrease in strength, suggesting that the postoperative surgical impact on muscle functionality is greater in those patients
Summary
Cancer is a disease that compromises the nutritional status, leading to morphological, functional, and metabolic changes. Nutritional status before surgery and how it is affected by the surgical trauma are determinant factors regarding postoperative loss of muscle mass and functional capacity[1]. Worsening of nutritional status directly impacts skeletal muscle fiber, leading to progressive loss of muscle mass and strength, and muscle function loss, known as sarcopenia[4]. Functional capacity loss negatively impacts patients’ daily routine activities, quality of life, early postoperative mobilization, and increases the risk of postoperative complications[5,6]. Protocols like ACERTO (Aceleração da Recuperação Total PósOperatória), and ERAS (Enhanced Recovery After Surgery) focus on the importance of prehabilitation, which is a combination of both physical exercises and adequate nutritional management, reducing postoperative complications, hospital stay and overall
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