Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Dieta Vegetariana/psicologia , Neoplasias Colorretais/prevenção & controle , Estados Unidos , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/psicologia , Sistema de Registros/estatística & dados numéricos , Risco , Incidência , Mortalidade , Comportamento Alimentar , Estilo de VidaRESUMO
Cephalic pancreaticoduodenectomy (CPD) is the surgical procedure of choice for curative resection of pancreatic head and periampullary tumors. Preoperative nutritional intervention is crucial for reducing postoperative complications since malnutrition can be found in patients with these tumors. This malnutrition can get even worse during the postoperative period due to fasting and subsequent treatments. Besides, the surgical procedure entails surgical resections that alter the digestive process and can have long-term negative effects on the nutritional status. An aspect infrequently assessed is the alteration of exocrine and endocrine functions after surgery, that noticeably affects both the metabolic and general status of these patients. As regards long-term nutrition, there is no consensus on how to evaluate patients who have undergone a pancreatic resection. Consequently, early nutritional intervention since diagnosis may prevent or lessen the deterioration of nutritional status resulting from the disease itself as well as from the surgery and from the long term. The alimentary and nutritional education that would help the patient gain an adequate control of his metabolism and nutrition becomes vital.
Assuntos
Desnutrição/etiologia , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Apoio Nutricional/métodos , Complicações Pós-Operatórias , Desnutrição/terapia , Estado Nutricional , Humanos , Neoplasias Pancreáticas/complicações , Pancreaticoduodenectomia/efeitos adversosRESUMO
La nutrición perioperatoria en cirugía mayor del tracto digestivo es un pilar básico dentro de la terapéutica de estos pacientes; considerando que un elevado porcentaje presenta malnutrición en el periodo preoperatorio y que es bien conocida la correlación entre la ingesta preoperatoria inadecuada y la aparición de complicaciones. Se presenta a continuación un caso clínico de sexo femenino a quien se realizó esofagectomía, que evolucionó con quilotórax en postoperatorio; y se describe el manejo nutricional que se llevó a cabo. El quilotórax, que es una complicación poco frecuente, tiene una mortalidad no despreciable debido a que produce alteraciones nutricionales, inmunológicas y de los fluidos corporales. El tratamiento adecuado es controvertido. Los principios del tratamiento conservador son reducir el flujo de quilo, drenar la cavidad pleural, prevenir las complicaciones sépticas y aportar nutrición enteral con triglicéridos de cadena media que van directamente al sistema porta o nutrición parenteral.