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Preoperative Assessment and Optimization of the Cancer Patient for Onco-Surgery

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Textbook of Onco-Anesthesiology

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Abstract

The onco-surgical interventions require a thorough preoperative assessment that includes the global assessment of the cancer patient, focusing on their past medical and surgical history as well as their oncological history and neoadjuvant therapies. Chemotherapy and radiation therapy have important acute and chronic side effects that must be appreciated before anesthesia. Risk stratification and prognostication are crucial matters to consider in preparation of the patient for anesthesia and onco-surgery. Prehabilitation is an emerging concept for patients undergoing surgical interventions and there is some evidence that addressing modifiable risk factors may affect treatment outcomes. The prehabilitation goal is primarily to increase the physiological reserves to tolerate the stress of the perioperative period better. The impact of various prehabilitative aspects needs to be researched further in specific surgical interventions. Various testing need to be individualized. In high-risk surgical interventions, newer assessment modalities like cardiopulmonary exercise testing provide a holistic overview of cardiorespiratory function and can detect clinically occult heart disease. Further research is needed, however, before this expensive test is more widely implemented.

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Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, University of Texas, Houston, TX, USA

    Linh Trang Nguyen & Shannon M. Popovich

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  1. Linh Trang Nguyen
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  2. Shannon M. Popovich
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Correspondence to Shannon M. Popovich .

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Editors and Affiliations

  1. Department of Onco-Anaesthesia and Palliative Medicine, DR BRAIRCH, All India Institute of Medical Sciences, New Delhi, India

    Rakesh Garg

  2. Department of Onco-Anesthesiology and Palliative Medicine, Dr BRAIRCH and National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India

    Sushma Bhatnagar

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Nguyen, L.T., Popovich, S.M. (2021). Preoperative Assessment and Optimization of the Cancer Patient for Onco-Surgery. In: Garg, R., Bhatnagar, S. (eds) Textbook of Onco-Anesthesiology. Springer, Singapore. https://doi.org/10.1007/978-981-16-0006-7_5

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  • DOI: https://doi.org/10.1007/978-981-16-0006-7_5

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  • Online ISBN: 978-981-16-0006-7

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