A prospective observational study of preoperative assessment and optimization of high risk surgical patients posted for gastrointestinal cancer surgeries and their perioperative outcomes

The number of patients undergoing surgery and other related invasive interventions has been growing over the years; along with a large population moving into the elderly population. Abdominal surgeries carry high perioperative risks with high risk populations carrying multiple and uncontrolled comorbidities. Periâ€operative medicine is based on improving the care of patients to maximize the quality of life. High-risk surgeries have been defined as those with a mortality of >5%. A number of scoring systems and diagnostic tests have been used to help identify patients and operations with high risk and allow appropriate management to be started early in the perioperative period. The most commonly used systems are the POSSUM score and ASA grading. Perioperative medicine aims include preoperative risk stratification using cardiopulmonary exercise testing for patients undergoing major abdominal surgery, preoperative management of iron deficiency and anemia, and preoperative exercise intervention.

Proof of the utilization and validity for improving surgical outcomes with such tools in preoperative care is still not well established and evidence-based developments in this field will likely be beneficial to patients undergoing major abdominal surgery, but further research into such fields is required.