Introduction: preparation for surgery and perioperative optimisation
Most patients diagnosed with colorectal carcinoma will undergo an operation. This may occur soon after diagnosis or may occur after neoadjuvant therapy in the case of rectal carcinoma, or after chemotherapy in patients with metastatic disease.
The decision to operate on an individual patient is based on an assessment of the patient’s cancer burden, but also on patient factors including pre-existing comorbidities and patient’s wishes.
Adequate pre-operative assessment will vary between patients, but in addition to pre-operative cancer staging, it should incorporate blood tests (including anaemia screening, electrolytes and CEA levels) cardiopulmonary testing in selected patients, and referral to specialist services including a perioperative physician if necessary.
Patients having elective colorectal cancer surgery should ideally be seen in a pre-admission clinic if available, and/or by an anaesthetist if possible.
A variety of measures and interventions can be used in the perioperative period to improve patient outcomes in the short and long term.
Chapter subsections[edit source]
Please see sections:
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