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Clinical Conditions: Bariatric Surgery

All cancer patients with diagnosis of nutritional risk and/or malnutrition should receive individualized nutritional therapy (NT) immediately, provided they are hemodynamically stable for at least one week (1,2).

The objectives of NT for these patients, both in the preoperative and postoperative period, are (1):

-to prevent or revert the decrease of nutritional condition;

-to prevent progression to cachexia;

-to help in the management of symptoms;

-to improve the nitrogen balance;

-to reduce proteolysis;

-to improve the immune response;

-to reduce the length of hospital stay;

-to improve the patient’s quality of life.

One of the major complications caused by cancer is malnutrition. Its cause is multifactorial, which may come from the tumor-induced anorexia, pain or obstruction of the gastrointestinal tract, anticancer therapy itself (surgery, radiotherapy and/or chemotherapy), and changes in the patient\'s metabolism. These changes lead to loss of body fat and protein. Scientific study conducted in lung cancer patients showed that, with 30% of body weight loss, patients experienced 85% decrease in fat mass and 75% loss of muscle skeletal mass (1).

Since malnutrition is associated with increased morbidity, mortality and decreased tolerance of patients to treatment, NT, combined with the cancer treatment, helps create favorable conditions for improving the use of nutrients and for preventing significant changes in weight loss and nutritional condition, providing better health conditions and contributing to the patient’s recovery (2).

References

1. Consenso Nacional de Nutrição Oncológica do Instituto Nacional de C\'ncer (INCA). (http://bvsms.saude.gov.br/bvs/publicacoes/consenso_nacional_nutricao_oncologico.pdf) [Oncology Nutrition National Consensus of Instituto Nacional do Câncer (INCA). (http://bvsms.saude.gov.br/bvs/publicacoes/consenso_nacional_nutricao_oncologico.pdf)]

2. Waitzberg DL. Nutrição oral, enteral e parenteral na prática clínica. 4. ed. São Paulo: Atheneu, 2009.

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