Preoperative Evaluation in Colorectal Patients
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
Citation
Landmann, Ron G, and Todd D Francone. "Preoperative Evaluation in Colorectal Patients." ASCRS Textbook of Colon and Rectal Surgery, 2022. ASCRS U, www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285056/all/Preoperative_Evaluation_in_Colorectal_Patients.
Landmann RG, Francone TD. Preoperative Evaluation in Colorectal Patients. ASCRS Textbook of Colon and Rectal Surgery. 2022. https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285056/all/Preoperative_Evaluation_in_Colorectal_Patients. Accessed June 8, 2023.
Landmann, R. G., & Francone, T. D. (2022). Preoperative Evaluation in Colorectal Patients. In ASCRS Textbook of Colon and Rectal Surgery https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285056/all/Preoperative_Evaluation_in_Colorectal_Patients
Landmann RG, Francone TD. Preoperative Evaluation in Colorectal Patients [Internet]. In: ASCRS Textbook of Colon and Rectal Surgery. ; 2022. [cited 2023 June 08]. Available from: https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285056/all/Preoperative_Evaluation_in_Colorectal_Patients.
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