Efeitos da associação de orientações nutricionais e terapia complexa descongestiva associada no linfedema de mulheres com sobrepeso mastectomizadas

Abstract

Introduction: Breast cancer is the most frequent type of neoplasm in the Brazilian female population, with upper limb lymphedema being the main complication resulting from surgery. Objective: The study aimed to evaluate the effects of nutritional guidance associated with complex decongestive therapy in the treatment of mastectomies overweight patients with lymphedema. Material and Methods: It is a clinical trial, interventional, controlled, longitudinal and randomized study. The study evaluated 40 overweight participants with breast cancer, who underwent mastectomy with axillary dissection, with lymphedema and, aged > 18 years. 20 participants in group I (intervention) underwent complex decongestive therapy associated with modified nutritional guidance, and 20 participants in group II (control) underwent complex decongestive therapy. All measurements were performed at three checkpoints of the study (0, 30, 60) days after the beginning of treatment. Results: participants in group I (intervention) showed a significant reduction in weight, BMI, muscle weight and protein ratio over the study period (p= 0.018 and p= 0.024); (p= 0.015 and p= 0.026); (p=0.006 and p=0.004); (p=0.049); (p=0.025). On the other hand, there was no significant difference in the measurements: body fat rate (p=0.649) (p=0.358) (p=0.716), lean mass (p=0.332) (p=0.586) (p=0.290 ), body fat (p=0.594) (p=0.129) (p=0.737), visceral fat (p=0.702) (p= 0.234) (p= 0.624), bone mass (p=0.317) (p=0.748) (p=0.313), bone mass moisture (p=0.853) (p=0.480) (p=0.911), muscle mass (p=0.696) (p=0.763) (p=0.700), basal metabolic rate (p =0.398) (p=0.127) (p=0.469), body age (p=0.611) (p=0.428) (p=0.507). Regarding the measurement of arm circumference, there was a significant reduction analyzing 7 and 14 cm in group 1 in comparison to group 2 (p<0.001 and p=0.001), arm (p=0.018 and p=0.001 forearm (p=0.004 and p=0.001); hand (p<0.001 and p=0.022). Participants in both groups on the Visual Analogue Scale demonstrated a significant reduction in pain sensation (p<0.001); (p<0.001); (p<0.001). Conclusion: Complex decongestive therapy associated with a nutritional guidance showed a reduction in lymphedema in patients who underwent mastectomy/quadrantectomy.