Resumo: O linfedema de Membro Superior (MS) e a principal complicacao decorrente da cirurgia e tratamento do cancer (CA) de mama e e causado pela destruicao dos canais de drenagem axilar em virtude da cirurgia, radioterapia ou pela progressao regional da doenca. Esta pesquisa teve o intuito de verificar a influencia da ingestao de triglicerideos de cadeia media (TCM) associada ao tratamento fisioterapeutico em mulheres portadoras de linfedema de MS pos-cirurgia de CA de mama. Para tanto, teve a participacao de 14 mulheres mastectomizadas que apresentavam linfedema de MS homolateral a cirurgia, com idade media de 64}12 anos e Indice de Massa Corporea (IMC) de 27}4,1 kg/m2. Apos avaliacao nutricional foram divididas, aleatoriamente, em dois grupos: Grupo Controle (n=7), submetido ao tratamento fisioterapeutico constando da terapia complexa descongestiva (massagem classica, drenagem linfatica manual, bandagem compressiva e cuidados com a pele), 3 vezes na semana, durante 8 semanas e automassagem nas 2 semanas seguintes; Grupo TCM (n=7), submetido ao mesmo protocolo fisioterapeutico somado ao tratamento dietetico diario com ingestao de TCM, por 10 semanas. O linfedema foi avaliado atraves da cirtometria, da volumetria, das pregas cutaneas e pela quantidade de agua corporal total. As sensacoes de desconforto, peso e dor no MS acometido foram coletadas por escalas visuais analogas (EVA). Ao final da intervencao, a cirtometria, a volumetria e as pregas cutaneas tricipital e bicipital mostraram diferencas significativas entre os grupos (p.0,05), com uma maior reducao do linfedema no grupo TCM. As sensacoes de desconforto e peso no membro foram significativamente menores na comparacao inicial e final no grupo TCM. Nao houve diferencas na quantidade de agua corporal total. / Abstract: The lymphedema of upper-extremity (UE) is the main complication due to the surgery and treatment of the breast cancer and it is caused by the destruction of the channels of axillary drainage because of the surgery, radiation therapy or by the local progression of the disease. This research had the intention of verifying the influence of the intakes of medium chain triglycerides (MCT) associated to the physiotherapeutic treatment in the lymphedema of the upper-extremity of postmastectomy women. For this research, it counted with the participation of 14 postmastectomy women who presented lymphedema of upper-extremity at the same side to the surgery, with medium age 64}12 years old and Body Mass Index (BMI) of 27}4,1 kg/m2. After nutritional evaluation they were divided, at ramdom, in two groups: Control Group (n=7), submitted to the physiotherapeutic treatment consisting of the complex decongestive therapy (classic massage, manual lymphatic drainage, compression bandage and cares with the skin), three times a week, during eight weeks and self-massage in the two following weeks; MCT Group (n=7), submitted to the same physiotherapeutic protocol in addition to the daily dietotherapy with intakes of MCT, during ten weeks. The lymphedema was evaluated by the circumferential and volumetric measures, by skin folds of arm with lymphedema and by the amount of total body water. The sensations of discomfort, pain and weight in the UE were collected by visual analogue scales (VAS). At the end of the intervention, the circumferential and volumetric measures, and the tricipital and bicipital skin folds showed significant differences among the groups (p.0,05), with a larger reduction of the lymphedema in the MCT Group. The sensations of discomfort and weight in the UE were significantly smaller in the final comparison related to the initial in the MCT Group. / Orientador: Thais Borges César / Coorientador: João Bosco Faria / Banca: Luciana Maria Malosa Sampaio Jorge / Banca: Flávia Berwert Bellarde / Mestre

Resumo: Identificar as repercussões estruturais, funcionais e na qualidade de vida de mulheres submetidas à vulvectomia e linfadenectomia inguinal para tratamento cirúrgico do câncer de vulva. Estudo observacional, prospectivo, transversal. Foram avaliadas 28 mulheres submetidas ao tratamento cirúrgico para câncer de vulva e 28 mulheres saudáveis (grupo controle), pareadas por idade. Os dados demográficos e clínicos referentes ao câncer de vulva foram obtidos por meio de análise de registros médicos, entrevista, exame físico e dos questionários: European Organization for Reseach and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30), para qualidade de vida, International Consultation on Incontinence Questionnare - Short Form (ICIQ-SF), para avaliação da função urinária e o The Female Sexual Function Index (FSFI), para avaliar a função sexual. Os testes estatísticos utilizados foram qui-quadrado, t de Student, Spearman e Mann Whitney-U. A ocorrência de linfedema foi maior nas pacientes com câncer de vulva em comparação ao controles (p<0,05). O linfedema foi mais grave nas pacientes tratadas para câncer de vulva em comparação ao controle (p=0,003). Não houve diferença entre a gravidade do linfedema e as variáveis: estadiamento, tratamento adjuvante, lateralidade do linfedema e complicações. Houve associação entre gravidade do linfedema e as variáveis idade (p=0,04) e IMC (p=0,04). As escalas de qualidade de vida, definidas pelos domínios: físico, cognição, emocional, social, fadiga, dor, sono, e questões financeiras; se associaram com a gravidade do linfedema (p<0,05). Não houve influência das variáveis: estado civil, escolaridade, menopausa e câncer de vulva na qualidade de vida sexual. Houve associação entre qualidade de vida sexual com a idade (p=0,01) e parceiro estável (p=0,01). As variáveis: IMC, menopausa e câncer de vulva... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: To identify the impact structural, functional and quality of life of women before vulvectomy and inguinal lymphadenectomy for surgical treatment of cancer of the vulva. Observational, prospective, cross. We evaluated 28 women undergoing surgical treatment for cancer of the vulva and 28 healthy women (control group), matched for age. The demographic and clinical data relating to cancer of the vulva were obtained through analysis of medical records, interview, physical examination and questionnaires: European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) for quality of life, International Consultation on Incontinence Questionnaire - Short Form (SF-ICIQ) for assessment of urinary function and The Female Sexual Function Index (FSFI) to assess sexual function. Statistical tests used were chi-square, t Student, Spearman and Mann-Whitney-U. The incidence of lymphedema was higher in patients with cancer of the vulva as compared to controls (p <0.05). The lymphedema was more severe in patients treated for cancer of the vulva as compared to control (p = 0003). There was no difference between the severity of lymphedema and the variables: stage, adjuvant treatment, laterality and complications of lymphedema. There was an association between severity of lymphedema and the variables age (p = 0.04) and BMI (p = 0.04). The scales of quality of life, defined by domains: physical, cognitive, emotional, social, fatigue, pain, sleep, and financial issues, became associated with the severity of lymphedema (p<0.05). There was no influence of variables: marital status, educational level, menopause and cancer of the vulva in the quality of sexual life. There was an association between sexual quality of life with age (p = 0.01) and stable partner (p = 0.01). The variables: BMI, menopause and cancer of the vulva did not influence... (Complete abstract click electronic access below) / Orientador: Agnaldo L. Silva Filho / Coorientador: Elyonora M. Figueiredo / Banca: Paulo Traiman / Banca: Sérgio Augusto Triginelli / Mestre