RESUMO
OBJECTIVE: To determine a simplified method for nutritional status evaluation in surgical patients to identify patients prone to develop complications. METHODS: A prospective study was carried out to determine prognostic index of patients in whom major abdominal surgery was performed, based on nutritional assessment. We proposed a simplified and accessible method for daily evaluation of patients in any hospital even in an emergency setting. The following parameters were used: complete blood count (CBC); blood chemistry (BC); protrombine time (PT); total serum protein (TSP), and anthropometrics. RESULTS: Study population consisted of 200 patients divided in two groups depending on type of surgical intervention, i.e., emergency or elective procedure. Complications associated with different stages of malnourishment were analyzed by simplified nutritional assessment system. Of 200 patients analyzed, 123 had several stages of malnutrition, 62 were malnourished, complicated patients (50.41%), and 77 had adequate nutritional status; of these, 10 also had complications (12.99%). DISCUSSION: We were able to conclude that simplified nutritional assessment system is not a useful absolute predictive indicator of possible complications. However, some parameters could be useful to identify patients with nutritional depletion with tendency for post-surgical complications.
Assuntos
Desnutrição/diagnóstico , Avaliação Nutricional , Cuidados Pré-Operatórios , Procedimentos Cirúrgicos Operatórios , Adolescente , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
OBJECTIVE: To determine advantages and disadvantages of manual vs mechanical sutures in colon surgery. MATERIAL AND METHODS: A retrospective study of clinical files of 84 colon surgery patients was conducted, to establish morbidity and mortality of these patients with special emphasis in length of surgical procedure and type of suture used during procedure (either manual or mechanical). RESULTS: Of 84 patients included in this study, manual suture was used in 70 (group 1) and mechanical suture in 14 (group 2). Most common preoperative diagnosis was diverticular disease in 22 cases (26.2%), 20 for group with manual suture, and two for group with mechanical suture. Most common surgical procedure was colectomy with ileoproctoanastomosis in group 1 and lower anterior resection with coloproctoanastomosis in group 2. Five cases presented complications (2.85%) with manual suture, while only one case presented complications in group 2 (7.14%). Main complications were dehiscence in group 1 and stenosis in group 2. DISCUSSION: There were no significant differences between both types of suture in terms of time of surgical procedure; there were no statistical differences for both techniques in terms of morbidity and mortality. However, there is shorter time of recovery in patients in whom mechanical suture was used with less tissue edema due to manipulation and less disability period.