ABSTRACT Objective: To determine new body mass index (BMI) reference values to classify the nutritional status of children aged six to ten years old from the city of Montes Claros (state of Minas Gerais), Southeast Brazil. Methods: The sample consisted of 3,863 individuals from both genders. Body mass and height were measured to determine the BMI. We adopted the Lambda, Mu, and Sigma (LMS) method to obtain the cut-off points. After that, each stratum curve was smoothed using quartic polynomials by gender. Average interpolation was used to determine the biannual distribution values. We calculated the 3rd, 85th, and 95th centiles to classify underweight, overweight, and obesity, respectively, according to gender and age. Results: After tabulating the LMS parameters at biannual intervals by gender, we plotted a graphic with seven centiles of BMI distribution and calculated the new BMI parameters for children aged 6-10 years old from the city of Montes Claros. The cut-off values for underweight, overweight, and obesity classification were, respectively, 17.5, 25 and 30 kg/m2. Conclusions: For the studied children, the use of traditional BMI references may result in the overestimation of underweight and underestimation of overweight and obesity. Studies should be carried out with periodic updates, respecting the characteristics of each location in order to use BMI reference values to classify the nutritional status of children and adolescents.

RESUMO Objetivo: Determinar novos valores de referência do índice de massa corporal (IMC) para a classificação do estado nutricional de crianças de seis a 10 anos da cidade de Montes Claros (MG) Brasil. Métodos: Foi utilizada uma amostra de 3.863 sujeitos de ambos os sexos, sendo mensurados massa corporal e estatura para a determinação do IMC. Para a obtenção dos pontos de corte utilizou-se o método Lambda, Sigma e Mu (LMS). Em seguida, as curvas de cada estrato foram suavizadas por polinômios de 4º grau por sexo, e, por interpolação das médias aritméticas, foram obtidos os valores semestrais da distribuição. Foram calculados os percentis 3%, 85% e 95% para a classificação de baixo peso, sobrepeso e obesidade, respectivamente, de acordo com sexo e idade. Resultados: Após a tabulação em intervalos semestrais dos valores dos parâmetros LMS por sexo, foi possível construir o gráfico com sete centis da distribuição do IMC, sendo apresentados os novos parâmetros do IMC para crianças de 6 a 10 anos de Montes Claros, equivalentes aos valores 17,5, 25 e 30 kg/m2 para baixo peso, sobrepeso e obesidade respectivamente. Conclusões: Em relação à população de Montes Claros, a utilização das tradicionais referências para o IMC pode resultar em uma superestimativa do baixo peso e subestimativa do sobrepeso e obesidade. O que se sugere é que, para o uso de valores de referência do IMC para classificar o estado nutricional de crianças e adolescentes, sejam realizados estudos com atualizações periódicas, respeitando as características de cada localidade.

ABSTRACT: Sorghum breeding programs are based predominantly on developing homozygous lines to produce single cross hybrids, frequently with relatively narrow genetic bases. The adoption of complementary strategies, such as genetic diversity study, enables a broader vision of the genetic structure of the breeding germplasm. The purpose of this study was to evaluate the genetic diversity of sorghum breeding lines using structure analysis, principal components (PC) and clustering analyses. A total of 160 sorghum lines were genotyped with 29,649 SNP markers generated by genotyping-by-sequencing (GBS). The PC and clustering analyses consistently divided the R (restorer) and B (maintainer) lines based on their pedigree, generating four groups. Thirty-two B and 21 R lines were used to generate 121 single-cross hybrids, whose performances were compared based on the diversity clustering of each parental line. The genetic divergence of B and R lines indicated a potential for increasing heterotic response in the development of hybrids. The genetic distance was correlated to heterosis, allowing for the use of markers to create heterotic groups in sorghum.

Resumen Antecedentes: La rinitis alérgica es la enfermedad alérgica más común en el mundo y es causada por hipersensibilidad a los aeroalérgenos. Hasta donde sabemos, no hay estudios previos de sensibilización aeroalergénica en Aguascalientes, México. Objetivo: Describir la sensibilización a aeroalérgenos en pacientes con rinitis alérgica tratados en una clínica privada en Aguascalientes, México. Métodos: Estudio descriptivo, transversal y retrospectivo; se incluyeron pacientes diagnosticados con rinitis alérgica. Se realizaron pruebas cutáneas con 32 extractos alergénicos y se determinaron las frecuencia de reacción a cada uno. Resultados: En total se analizaron 350 pacientes. Los aeroalérgenos más frecuentes fueron los pólenes de pastos (74.8%), seguidos por los pólenes de árboles (64.8%) y Dermatophagoides pteronyssinus (64%). El grupo de edad predominante fue el menor de 20 años (67.1%), seguido del grupo de 21 a 40 años (22.5%). Conclusión: La investigación proporciona información sobre los patrones regionales de sensibilización, que facilitará las pruebas de diagnóstico en la región y las mejores prácticas de inmunoterapia específica.

Abstract Background: Allergic rhinitis is the most common allergic disease worldwide and it is caused by a reaction of hypersensitivity to aeroallergens. To our knowledge, there aren’t any previous studies of aeroallergenic sensitization in Aguascalientes, Mexico. Objective: To describe the sensitization to aeroallergens in patients with allergic rhinitis who have been treated at a private clinic in Aguascalientes, Mexico. Methods: A descriptive, cross-sectional and retrospective study was done in which patients diagnosed with allergic rhinitis were included. Skin prick tests with 32 allergenic extracts were carried out and the frequencies at each were determined. Results: In total, 350 patients were analyzed. The most frequent aeroallergens were grass pollens (74.8%), followed by tree pollens (64.8%) and dust mites Dermatophagoides pteronyssinus (64%). The group of patients under 20 years of age was predominant (67.1%), followed by the group of 21 to 40 years old (22.5%). Conclusion: This research provides information about regional patterns of sensitization, which shall facilitate diagnostic tests in the region and the best practices of specific immunotherapy.

RESUMEN La actividad porcina genera diariamente una gran cantidad de residuos conformados por nutrientes y microorganismos que potencialmente contribuyen a la contaminación de agua, aire y suelos, y la subsecuente generación de olores desagradables. Diversas estrategias se han desarrollado para mitigar el efecto contaminante de las excretas porcinas y aprovechar sus nutrientes; tal es el caso del ensilaje, que consiste en la fermentación de las excretas. En este estudio se evaluó el efecto del ensilaje del estiércol porcino adicionado con dos fuentes diferentes de carbohidratos y dos fuentes de bacterias ácido lácticas, sobre la reducción de diferentes grupos de microorganismos. Durante el proceso se observó la disminución del pH (hasta 4.6) y la carga microbiana, sobre todo para organismos coliformes (reducción mayor a 5 logaritmos) y hongos y levaduras, así como la eliminación total del grupo de enterococos; mientras que el contenido de bacterias ácido lácticas, principales responsables de la fermentación, permaneció constante. Los mejores resultados se observaron mediante el uso de sorgo como fuente de carbohidratos en combinación con suero de leche, subproducto de la elaboración de queso, como fuente de bacterias ácido lácticas, tanto en disminución del pH como en la reducción de algunos indicadores microbiológicos, incluidas las bacterias productoras de ácido sulfhídrico. Mediante el ensilaje del estiércol porcino se favorece la disminución del pH por acción de las bacterias ácido lácticas a niveles que limitan la sobrevivencia de microorganismos asociados a contaminación fecal, y lo transforman en un producto seguro, desde la perspectiva microbiológica, para su manejo y posible aprovechamiento subsecuente.

ABSTRACT Swine production generates every day a large amount of residues, including nutrients and microorganisms, which potentially contribute to contamination of air, water and soil, and generation of unpleasant odors. Many strategies have been developed in order to mitigate the contaminant effect of swine manure and to take advantage of its nutrients and beneficial compounds; silage is an example of these, and consists in swine manure fermentation mainly under anaerobic conditions. The aim of this study was to assess the effect of applying a process of silage to swine manure added with two different sources of carbohydrates and two different sources of lactic-acid bacteria, under the reduction of different microbiological indicators. Through the process, it was observed the reduction of pH levels (until reaching 4.6) and microbial content, mainly for coliforms (reduction greater than 5 log), molds and yeasts, and total elimination of enterococci. On the other hand, significant decline was not reported for the lactic-acid bacteria content, main responsible of fermentation process. Best results were observed through using sorghum as a source of carbohydrates and cheese whey as a source of lactic-acid bacteria, for both, decrease of pH and reduction of some microbiological indicators, including bacteria that produce sulfuric acid. Therefore, silage process, applied to swine manure, induces the decrease of pH for action of lactic-acid bacteria until limit the survival of bacteria associated with fecal contamination, making of swine a transformed and microbiologically safe residue for its handling and subsequent use.

ABSTRACT Objective: To compare postoperative radiographic outcomes of Schatzker type V and VI tibial plateau fractures treated with double-plate or single lateral locked plate. Methods: Sixty-three patients operated from December 2011 to February 2016 were selected, 47 from the double-plate group and 16 from the single lateral locked plate group. Minimum follow-up for all patients was 6 months. Fracture reduction evaluation was based on radiographic parameters: joint reduction, sagittal alignment, coronal alignment, and condylar width. Results: Radiographic evaluation showed no statistical difference in the immediate or late postoperative periods. Conclusion: Despite the reduced sample, this study is aligned with current results published in the medical literature. The severity of Schatzker type V and VI tibial plateau fractures can be minimized by the correct indication for the implant regarding fracture morphology. Level of Evidence III, Retrospective comparative study.

RESUMO Objetivo: Comparar desfechos radiográficos pós-operatórios de fraturas do planalto tibial Schatzker V e VI tratados com dupla placa ou placa bloqueada única lateral. Métodos: Foram selecionados 63 pacientes operados no período de dezembro de 2011 a fevereiro de 2016, sendo 47 do grupo dupla placa e 16 do grupo placa bloqueada lateral única. Todos os pacientes tiveram seguimento mínimo de seis meses. A avaliação da redução das fraturas foi baseada nos parâmetros radiográficos: redução articular, alinhamento sagital, alinhamento coronal e largura condilar. Resultados: A avaliação radiográfica não demonstrou diferença estatística no pós-operatório imediato nem no tardio. Conclusão: Apesar da amostra reduzida, o estudo vai ao encontro dos resultados mais atuais publicados na literatura médica. A gravidade das fraturas do planalto tibial Shatzker V e VI pode ser minimizada com a correta indicação do implante segundo a morfologia da fratura. Nível de Evidência III, Estudo retrospectivo comparativo.

RESUMEN Este estudio etnográfico fue diseñado para explorar las condiciones de vida de un grupo de familias aborígenes residentes en un contexto urbano, beneficiarias de un programa sociorecreativo en Sídney, Australia. El objetivo fue explorar la satisfacción vital mediante el análisis de sus condiciones de vida y del capital cultural inscrito en sus actitudes, percepciones y conocimientos establecidos. El trabajo de campo se estructuró en dos fases complementarias: en la fase 1, entre mayo de 2008 y diciembre de 2010, se inició con el ingreso del primer autor como voluntario en la asociación responsable del programa y, en la fase 2, entre enero de 2011 y febrero de 2013 se intensificó el proceso de observación participante y las entrevistas semiestructuradas. Los resultados muestran que el proceso de desarraigo cultural está en la base de las experiencias vitales de desigualdad social experimentadas y apunta a un efecto de cohorte que llega hasta nuestros días. Dicho proceso de (des)consonancia cultural debe ser tenido en cuenta como un factor clave a la hora de analizar las condiciones de vida y bienestar de estas minorías étnicas, así como a la hora de desarrollar programas e intervenciones.

ABSTRACT This ethnographic study was designed to explore living conditions among a group of aboriginal families residing in an urban context, who participated in a recreational social program. The aim of the study was to explore life satisfaction by analyzing their living conditions and cultural capital inscribed in established attitudes, perceptions, and lay knowledge. Fieldwork was carried out in two complementary phases: phase 1, between May 2008 and December 2010, began when the first listed author initiated volunteer work with the organization responsible for the program; in phase 2, which extended from January 2011 to February 2013, participant observation was intensified and semi-structured interviews were carried out. The results indicate that the process of cultural uprooting underscores the experience of social inequality, and suggest a cohort effect that continues to this day. This process of cultural (in)consonance must be taken into account as a key factor when analyzing the living conditions and well-being of ethnic minorities, as well as when developing programs and interventions.

Resumo: Embora os girinos de anuros sejam amplamente distribuídos e abundantes em habitats aquáticos tropicais, não há chaves taxonômicas suficientes para as espécies da Mata Atlântica. Aqui, desenvolvemos uma chave dicotômica para identificar os girinos de todas as espécies com fase larval conhecida e já registradas nesse bioma, ao norte do rio São Francisco. Nós analisamos características discretas de 1.042 girinos pertencentes a 63 espécies (28 gêneros) de 32 localidades. Esta chave de identificação inclui ilustrações e imagens, sendo um passo significativo para um melhor conhecimento dos girinos da Mata Atlântica.

Abstract: Although anuran tadpoles are widely distributed and abundant in tropical aquatic habitats, there is a lack of taxonomic keys for the Atlantic Forest. Herein, we developed a dichotomous key for identifying the tadpoles for all species with known larval phase and already recorded in the Atlantic Forest north of the São Francisco River. We analyzed discrete characteristics of 1,042 tadpoles encompassing 63 species of 28 genera from 32 localities. The user-friendly key includes illustration and pictures, and it is a significant step towards improving our knowledge of tadpoles of the Atlantic Forest.

RESUMEN Llevar a cabo un análisis más integral y profundo de las diferencias y desigualdades en salud requiere de una aproximación más amplia al estudio de las masculinidades y la salud de los hombres en el momento actual. Estamos ante un tema cuyo interés ha ido a la par de la creciente preocupación por los riesgos y vulnerabilidades específicas de los hombres, pero también de la necesidad de involucrarlos en programas con capacidad de promover cambios positivos en el orden de género hacia la equidad en salud. Este artículo resitúa este campo dentro de la salud pública, proporcionando una visión amplificada sobre la salud de los hombres dentro del debate de los determinantes sociales de la salud y el análisis de las desigualdades. Sobre la base de un enfoque relacional de género, se formulan una serie de recomendaciones orientadas a las políticas y la investigación, que consideramos pueden contribuir a avanzar en el estudio y el desarrollo de programas desde una perspectiva de género en salud.

ABSTRACT Comprehensive and in-depth analyses of differences and inequalities in health require a broad-based approach to the study of masculinities and men’s health. Interest in this issue has grown in parallel to increased concern over specific risks and vulnerabilities faced by men, but also due to the need to involve them in programs capable of promoting progress towards gender-based health equity. This article attempts to reframe these issues from the perspective of public health, providing a wider viewpoint on men’s health situated within debates on the social determinants of health and the analysis of health inequalities. Based on a relational gender approach, we formulate some recommendations regarding policy and research agendas, which we argue can contribute to advancing the study and development of programs from a gender-based perspective in health.

ABSTRACT Objective: Liver arterial irrigation is characterized by a high frequency of variations in its anatomy. The aim of the study was to describe the anatomic position of the right hepatic artery as a brunch of the superior mesenteric artery. Methods: A total of 5147 intravenous contrast-enhanced computed tomography scans of patients seen at the Radiology Service of the Passo Fundo Clinical Hospital (RS), from October 2016 to December 2017, were selected. 125 patients with anatomic variation of the right hepatic artery were selected. The findings were categorized by the variation of the vascular position, emergence from the superior mesenteric artery and the relationship with other structures. Results: The most frequent position was retropancreatic (88.8%), retroportal (76.8%) and post-choledocian (75.2%), emerging about 2.33 cm from the superior mesenteric artery. Conclusion: We have shown that most common variant of the right hepatic artery presents its posterior origin from the pancreatic and hepatic pedicle, and arises close to the origin of the superior mesenteric artery.

RESUMO Objetivos: A irrigação arterial hepática tem como característica a elevada frequência de variações da anatomia. O objetivo do estudo foi descrever o trajeto anatômico da artéria hepática direita quando originada da artéria mesentérica superior. Métodos: Foram analisadas 5147 tomografias computadorizadas com contraste endovenoso de pacientes atendidos no Serviço de Radiologia do Hospital de Clínicas de Passo Fundo - RS, no período outubro de 2016 a dezembro de 2017. Foram selecionados 125 pacientes portadores de variação anatômica da artéria hepática direita na origem. Os achados foram categorizados pela variação do trajeto vascular, emergência da artéria mesentérica superior e a relação com demais estruturas. Resultados: Obtivemos o trajeto mais frequente desta variação como retropancreático (88,8%), retroportal (76,8%) e pós-coledociano (75,2%), emergindo cerca de 2,33 cm da origem da artéria mesentérica superior. Conclusão: Demonstramos que na maioria das vezes, a artéria hepática direita variante, apresenta trajeto posterior ao pâncreas e ao pedículo hepático e emerge próxima da origem da artéria mesentérica superior.

Abstract The purpose of this research is to provide a current situation of the ISO 9001 standard in the manufacturing sector in Mexico, identifying the critical success factors, barriers and benefits of its implementation. A survey with 55 items in a five-point Likert scale, mainly focusing on quality managers, was used and was provided by e-mail and the social network LinkedIn, which obtain 172 complete responses. The ISO 9001 standard is one of the initial strategies to manage quality; however, the results exhibit some barriers that hinder its implementation. According to the seven quality principles for the implementation of the standard established by the International Organization for Standardization, the results showed that leadership and customer focus are the main factors to satisfactorily adopt the standard in the manufacturing sector in Mexico, and this helps the industry to achieve some benefits.

Resumen El objetivo de esta investigación es proporcionar una situación actual del Estándar ISO 9001 en el sector de manufactura en México identificando sus factores críticos de éxito, barreras y beneficios de su implementación. Se utilizó una encuesta con 55 ítems en una escala Likert de cinco puntos centrada principalmente en gerentes de calidad y distribuida por correo electrónico y la red social LinkedIn obteniendo 172 respuestas completas. El estándar ISO 9001 es una de las estrategias iniciales para gestionar la calidad, sin embargo, los resultados muestran algunas barreras que dificultan su implementación. De acuerdo con los siete principios de calidad para la implementación del estándar establecida por la Organización Internacional de Normalización, los resultados revelaron que el liderazgo y el enfoque al cliente son los principales factores para una adopción satisfactoria de la norma en el sector manufactura en México que ayuda a esta industria a lograr algunos beneficios.

RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.

ABSTRACT Objective: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. Methods: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. Results: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). Conclusion: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.

Resumen La toma de decisiones del consumidor es parte del proceso de compra. Por tanto, al ser un elemento relevante para la evaluación del proceso de compra, es esencial contar con mediciones válidas, confiables y culturalmente relevantes. Por esta razón, en este artículo se presenta el desarrollo y validación del inventario de toma de decisiones de compras (ITDC). La muestra general estuvo conformada por 518 participantes mexicanos, la cual se dividió aleatoriamente en dos, 300 para análisis exploratorios y 218 para análisis confirmatorios. Los resultados muestran que el ITDC, evaluado a partir de sus componentes generales de decisiones emocionales y razonadas en las compras, presenta altos índices de consistencia interna. El análisis factorial confirmatorio muestra buen ajuste a las dimensiones extraídas en los análisis exploratorios. En términos de validez convergente, divergente y discriminante, se encontraron relaciones según la red nomológica, y los factores mostraron independencia. Por último, a partir de las estructuras confirmadas del inventario, se modeló el gasto por semana. Encontrando que las decisiones emocionales resultan ser un predictor significativo positivo. ITDC es una herramienta de evaluación con relevancia cultural e índices psicométricos apropiados, que se pueden utilizar para integrar en modelos de comportamiento del consumidor.

Abstract Consumer decision-making is part of the purchase process. Therefore, as a relevant element for the evaluation of the purchase process, it is essential to have valid, reliable and culturally relevant measurements. For that reason, in this study the development and validation of the Purchases Decision-Making Inventory (PDMI) are presented. The general sample consisted of 518 Mexican participants, which were randomly divided into two groups, 300 for exploratory analysis, and 218 for confirmatory analysis. The results show that PDMI evaluated from its general components of emotional and reasoned decisions in purchases, present high internal consistency. The confirmatory factor analysis shows a good fit to dimensions extracted from the exploratory analyses. In terms of convergent, divergent, and discriminant validity, relations according to the nomological network were found, and the factors showed independency. Finally, from the confirmed structures of the inventory, spending per week was modelled, finding that emotional decisions turned out to be a positive significant predictor. PDMI is an evaluation tool with cultural relevance and appropriate psychometric indexes that can be used to integrate into consumer behavior models.

RESUMO Objetivo: avaliar se a laparoscopia com lavado peritoneal é superior à tomografia computadorizada para o estadiamento do adenocarcinoma gástrico e se pode modificar a conduta cirúrgica do paciente. Métodos: estudo retrospectivo de 46 pacientes portadores de adenocarcinoma gástrico tratados pela equipe de cirurgia digestiva do Hospital de Clínicas de Passo Fundo (RS), de janeiro de 2015 a dezembro de 2018, e submetidos à laparoscopia com lavado peritoneal pré-operatório. Todos os pacientes foram submetidos ao estadiamento clínico pré-operatório com tomografia computadorizada. Resultados: dos 46 pacientes analisados, a maioria apresentava tumores localizados na cárdia (34,8%), pouco diferenciados (69,6%) e do subtipo células em anel de sinete (65,2%). Em 91,3% deles a tomografia computadorizada não identificou carcinomatose peritoneal ou metástases à distância. Entre estes pacientes com tomografia computadorizada negativa para doença à distância, 21,8% apresentaram lavado peritoneal positivo para células neoplásicas e tiveram suas condutas terapêuticas modificadas. Conclusão: a laparoscopia e o lavado peritoneal alteraram a decisão cirúrgica em 21,8% dos pacientes, proporcionando um estadiamento pré-operatório mais fidedigno no adenocarcinoma gástrico.

ABSTRACT Objective: to assess whether laparoscopy with peritoneal lavage is superior to computed tomography for staging gastric adenocarcinoma and whether it can modify the surgical approach. Methods: we conducted a retrospective study of 46 patients with gastric adenocarcinoma treated by the digestive surgery team of the Passo Fundo Clinics Hospital (RS), from January 2015 to December 2018, and submitted to laparoscopy with preoperative peritoneal lavage. All patients underwent preoperative clinical staging with computed tomography. Results: of the 46 patients analyzed, the majority had tumors located in the cardia (34.8%), poorly differentiated (69.6%), and subtype signet ring cells (65.2%). In 91.3%, the computed tomography scan did not identify peritoneal carcinomatosis or distant metastasis. Among these patients with negative computed tomography for distant disease, 21.8% had positive peritoneal lavage for neoplastic cells and had their therapeutic approaches modified. Conclusion: laparoscopy and peritoneal lavage altered the surgical decision in 21.8% of patients, providing a more reliable preoperative staging in gastric adenocarcinoma.