Preoperative Evaluation in Colorectal Patients

Ron G. Landmann, Todd D. Francone
Preoperative Evaluation in Colorectal Patients is a topic covered in the ASCRS Textbook of Colon and Rectal Surgery.

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Key Concepts

  • Patients undergoing elective abdominal colorectal operations are in the “intermediate” risk group for perioperative morbidity and mortality.
  • Recognition and optimization of concomitant patient pathophysiology are paramount in minimizing sepsis (anastomotic leak, surgical site infection), complications, and overall morbidity.
  • These include cardiopulmonary, renal, metabolic, and endocrine physiology and other pathophysiologic risk factors and derangements (such as frailty and immunosuppression).
  • Implementation of ACC/AHA guidelines and evidence-based medical management leads to improved efficiencies with minimization of extraneous testing and delays, while preserving low complication rates.
  • Corticosteroids and immunosuppression remain significant determinants of morbidity in patients undergoing intestinal colorectal surgery.
  • Prehabilitation of the frail and elderly patient is critical in optimizing patients for surgery while attempting to mitigate perioperative morbidity and mortality.

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Key Concepts

  • Patients undergoing elective abdominal colorectal operations are in the “intermediate” risk group for perioperative morbidity and mortality.
  • Recognition and optimization of concomitant patient pathophysiology are paramount in minimizing sepsis (anastomotic leak, surgical site infection), complications, and overall morbidity.
  • These include cardiopulmonary, renal, metabolic, and endocrine physiology and other pathophysiologic risk factors and derangements (such as frailty and immunosuppression).
  • Implementation of ACC/AHA guidelines and evidence-based medical management leads to improved efficiencies with minimization of extraneous testing and delays, while preserving low complication rates.
  • Corticosteroids and immunosuppression remain significant determinants of morbidity in patients undergoing intestinal colorectal surgery.
  • Prehabilitation of the frail and elderly patient is critical in optimizing patients for surgery while attempting to mitigate perioperative morbidity and mortality.

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Last updated: January 26, 2022