Dados do Trabalho

Título

RELAÇAO ENTRE O INDICE DE MASSA CORPOREA (IMC) E COMPLICAÇOES CIRURGICAS APOS CIRURGIA ONCOLOGICA MAMARIA.

Título em Inglês

RELATIONSHIP BETWEEN BODY MASS INDEX (BMI) AND SURGICAL COMPLICATIONS AFTER BREAST ONCOLOGICAL SURGERY

Introdução

Obesity is a multifactorial chronic disease that can predispose to several comorbidities including breast cancer. The Ministry of Health estimates the proportion of overweight in Brazil at 65%. The relationship between weight and height square (BMI) has been used by WHO to assess the degree of obesity in the population. Breast cancer is responsible for more than 8,000 deaths each year in Brazil. Despite advances in systemic treatment, surgery is one of the main treatments used and obesity is a relevant factor that worsens the oncological prognosis and is predictive of perioperative complications (1,2).

Objetivos

The aim of this study is to assess the relationship between obesity and surgical complications in 5,657 breast cancer patients undergoing surgical treatment (conservative or radical) at the Pérola Byington Hospital.

Métodos

A retrospective cross-sectional study was carried out with 5,657 patients undergoing surgical treatment (conservative or radical) by SUS at the Women's Health Reference Center-Hospital Pérola Byington from January 2011 to December 2019. Data were collected from the medical records of the Institution. The patients were divided into 6 groups according to BMI = P / H2 (<18.5 underweight, between 18.5 and 24.9 normal, 25 to 29.9 overweight, between 30 and 34.9 obese, 35 to 39.9 severe obese and over 40 for morbid obesity) and evaluated in relation to the different types of postoperative complications.

Resultados

According to the data obtained in our series, the most common surgical complication was dehiscence of the surgical scar, occurring in 80.5% of overweight women (BMI> 25), followed by hematoma, diagnosed in 72 patients, 59.7 % overweight women. The third most common complication was infection of the surgical site in only 19 patients (0.3%), with 78.9% in overweight women. This fact can be explained by inadequate perfusion, deficiency of macro and micronutrients and hypoxia that impairs collagen synthesis, resulting in poor healing, causing dehiscence. From these data presented, it is possible to infer that complications such as seroma, hematoma, infection of the surgical wound, dehiscence and even, loss of the surgical flap are strongly associated with increased body weight.

Conclusões

It is concluded that the increase in body weight, especially in patients with a BMI> 25, is an unfavorable factor for the occurrence of surgical complications in patients with breast cancer and it is essential to provide guidance on the risks of complications in the preoperative evaluation for adjust the best surgical procedure and mainly consider late reconstruction.

Palavras Chave

breast cancer; obesity; complications

Área

TREATMENT - Surgery and Reconstruction