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Perioperative care of the oncology patient

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Abstract

Cancer patients are often at high risk for perioperative complications because of preexisting conditions, the magnitude of surgery, and the use of aggressive multimodality treatment. It is essential to identify risk factors preoperatively, correct any deficits, and monitor organ dysfunction. During the perioperative period prophylaxis and surveillance for cardiopulmonary, hematologic, and septic complications should minimize morbidity and mortality. Finally, nutritional support should be given to malnourished patients undergoing extensive operative procedures.

Résumé

Les patients cancéreux sont souvent à haut risque pour faire une complication périopératoire en raison de leur maladie, l'importance du geste chirurgical, et l'aggresivité d'un traitement multidisciplinaire. Il est essentiel d'identifier en préopératoire les facteurs de risque et de corriger les déficits et de surveiller attentivement, pendant la période périopératoire, les organes particulièrement atteints. Une prophylaxie périopératoire des complications cardiopulmonaires, hématologiques et septiques devrait permettre de minimiser la morbidité et la mortalité. Les patients sous-alimentés devant avoir une intervention majeure, doivent recevoir un soutien nutritionnel.

Resumen

Los pacientes con cáncer con frecuencia tienen alto riesgo de desarrollar complicaciones postoperatorias debido a condiciones clínicas preexistentes, a la magnitud de la cirugía y a la utilización de agresivas terapias multimodales. Aparece esencial identificar preoperatoriamente los factores de riesgo, corregir los déficits existentes y monitorizar la disfunción orgánica. En el periodo preoperatorio la profilaxis y vigilancia de posibles complicaciones cardiopulmonares, hematológicas y sépticas deben minimizar la morbilidad y la mortalidad. Finalmente, se debe proveer soporte nutricional a pacientes desnutridos que vayan a ser sometidos a procedimientos quirúrgicos de gran magnitud.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

    Cathal J. Kelly B.Sc., F.R.C.S.I. & John M. Daly M.D.

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  1. Cathal J. Kelly B.Sc., F.R.C.S.I.
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  2. John M. Daly M.D.
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Kelly, C.J., Daly, J.M. Perioperative care of the oncology patient. World J. Surg. 17, 199–206 (1993). https://doi.org/10.1007/BF01658927

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