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Perioperative Assessment

  • Charlotte Kvasnovsky
  • Andrea Chao BaffordEmail author
Chapter
  • 5.3k Downloads

Abstract

Proper patient selection and perioperative management are the first steps to good postoperative outcomes in open and laparoscopic colorectal surgery. Laparoscopy, which combines pneumoperitoneum and patient position changes, results in unique physiologic alterations as compared to open surgery. This chapter discusses the effects and outcomes of laparoscopic colon and rectal surgeries as well as the selection, preoperative evaluation, and perioperative management of the laparoscopic colorectal surgery patient.

Keywords

Laparoscopic Surgery Surgical Site Infection Bowel Preparation Enhance Recovery After Surgery Laparoscopic Colorectal Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 1.1

Tattoo of a colonic lesion. Video by David E. Beck, MD (MP4 13,030 kb)

Video 1.2

Lighted ureteral stent on a left colectomy (MP4 12,443 kb)

References

  1. 1.
    Neuhaus SJ, Gupta A, Watson DI. Helium and other alternative insufflation gases for laparoscopy. Surg Endosc. 2001;15(6):553–60.PubMedCrossRefGoogle Scholar
  2. 2.
    Larsen JF, Svendsen FM, Pedersen V. Randomized clinical trial of the effect of pneumoperitoneum on cardiac function and haemodynamics during laparoscopic cholecystectomy. Br J Surg. 2004;91(7):848–54.PubMedCrossRefGoogle Scholar
  3. 3.
    Suh MK, Seong KW, Jung SH, Kim SS. The effect of pneumoperitoneum and Trendelenburg position on respiratory mechanics during pelviscopic surgery. Korean J Anesthesiol. 2010;59(5):329–34.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Bardoczky GI, Engelman E, Levarlet M, Simon P. Ventilatory effects of pneumoperitoneum monitored with continuous spirometry. Anaesthesia. 1993;48(4):309–11.PubMedCrossRefGoogle Scholar
  5. 5.
    Nguyen NT, Perez RV, Fleming N, Rivers R, Wolfe BM. Effect of prolonged pneumoperitoneum on intraoperative urine output during laparoscopic gastric bypass. J Am Coll Surg. 2002;195(4):476–83.PubMedCrossRefGoogle Scholar
  6. 6.
    Hedrick T, Turrentine F, Sanfey H, Schirmer B, Friel C. Implications of laparoscopy on surgery residency training. Am J Surg. 2009;197(1):73–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Scuderi PE, James RL, Harris L, Mims 3rd GR. Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy. Anesth Analg. 2000;91(6):1408–14.PubMedCrossRefGoogle Scholar
  8. 8.
    Benoist S, Panis Y, Beaufour A, Bouhnik Y, Matuchansky C, Valleur P. Laparoscopic ileocecal resection in Crohn’s disease: a case-matched comparison with open resection. Surg Endosc. 2003;17(5):814–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Kirat HT, Pokala N, Vogel JD, Fazio VW, Kiran RP. Can laparoscopic ileocolic resection be performed with comparable safety to open surgery for regional enteritis: data from national surgical quality improvement program. Am Surg. 2010;76(12):1393–6.PubMedGoogle Scholar
  10. 10.
    Magruder JT, Efron JE, Wick EC, Gearhart SL. Laparoscopic rectopexy for rectal prolapse to reduce surgical-site infections and length of stay. World J Surg. 2013;37(5):1110–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Klarenbeek BR, Veenhof AA, Bergamaschi R, et al. Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: a randomized control trial: short-term results of the Sigma Trial. Ann Surg. 2009;249(1):39–44.PubMedCrossRefGoogle Scholar
  12. 12.
    Hildebrandt U, Kessler K, Plusczyk T, Pistorius G, Vollmar B, Menger MD. Comparison of surgical stress between laparoscopic and open colonic resections. Surg Endosc. 2003;17(2):242–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Tan JJY, Tjandra JJ. Laparoscopic surgery for Crohn’s disease: a meta-analysis. Dis Colon Rectum. 2007;50(5):576–85.PubMedCrossRefGoogle Scholar
  14. 14.
    Stocchi L, Milsom JW, Fazio VW. Long-term outcomes of laparoscopic versus open ileocolic resection for Crohn’s disease: follow-up of a prospective randomized trial. Surgery. 2008;144(4):622–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Ahmed Ali U, Keus F, Heikens JT, Bemelman WA, Berdah SV, Gooszen HG, et al. Open versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis. Cochrane Database Syst Rev. 2009;(1):CD006267.Google Scholar
  16. 16.
    Liska D, Lee SW, Nandakumar G. Laparoscopic surgery for benign and malignant colorectal diseases. Surg Laparosc Endosc Percutan Tech. 2012;22(3):165–74.PubMedCrossRefGoogle Scholar
  17. 17.
    Nelson H, The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–9.CrossRefGoogle Scholar
  18. 18.
    Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26.PubMedCrossRefGoogle Scholar
  19. 19.
    Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Tjandra JJ, Chan MK. Systematic review on the short-term outcome of laparoscopic resection for colon and rectosigmoid cancer. Colorectal Dis. 2006;8(5):375–88.PubMedCrossRefGoogle Scholar
  21. 21.
    Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84.PubMedCrossRefGoogle Scholar
  22. 22.
    Nandakumar G, Fleshman JW. Laparoscopy for colon and rectal cancer. Clin Colon Rectal Surg. 2010;23(1):51–8.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Ng SS, Lee JF, Yiu RY, Li JC, Hon SS, Mak TW, et al. Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: a pooled analysis of 3 randomized controlled trials. Ann Surg. 2014;259(1):139–47.PubMedCrossRefGoogle Scholar
  24. 24.
    American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Practice advisory for preanesthesia evaluation: a report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2002;96(2):485–96.CrossRefGoogle Scholar
  25. 25.
    Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation. 2007;116(17):e418–99.PubMedCrossRefGoogle Scholar
  26. 26.
    Sheehy AM, Gabbay RA. An overview of preoperative glucose evaluation, management, and perioperative impact. J Diabetes Sci Technol. 2009;3(6):1261–9.PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Gustafsson UO, Thorell A, Soop M, Ljungqvist O, Nygren J. Haemoglobin A1c as a predictor of postoperative hyperglycaemia and complications after major colorectal surgery. Br J Surg. 2009;96(11):1358–64.PubMedCrossRefGoogle Scholar
  28. 28.
    Van Klei WA, Bryson GL, Yang H, Kalkman CJ, Wells GA, Beattie WS. The value of routine preoperative electrocardiography in predicting myocardial infarction after noncardiac surgery. Ann Surg. 2007;246(2):165–70.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Sheffield KM, McAdams PS, Benarroch-Gampel J, et al. Overuse of preoperative cardiac stress testing in medicare patients undergoing elective noncardiac surgery. Ann Surg. 2013;257(1):73–80.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Zibrak JD, O’Donnell CR. Indications for preoperative pulmonary function testing. Clin Chest Med. 1993;14(2):227–36.PubMedGoogle Scholar
  31. 31.
    Odejinmi F, Sangrithi M, Olowu O. Operative laparoscopy as the mainstay method in management of hemodynamically unstable patients with ectopic pregnancy. J Minim Invasive Gynecol. 2011;18(2):179–83.PubMedCrossRefGoogle Scholar
  32. 32.
    Chautard J, Alves A, Zalinski S, Bretagnol F, Valleur P, Panis Y. Laparoscopic colorectal surgery in elderly patients: a matched case-control study in 178 patients. J Am Coll Surg. 2008;206(2):255–60.PubMedCrossRefGoogle Scholar
  33. 33.
    Pikarsky AJ, Saida Y, Yamaguchi T, Martinez S, Chen W, Weiss EG, et al. Is obesity a high risk factor for laparoscopic colorectal surgery? Surg Endosc. 2002;16(5):855–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Delaney CP, Pokala N, Senagore AJ, Casillas S, Kiran RP, Brady KM, et al. Is laparoscopic colectomy applicable to patients with body mass index >30? A case-matched comparative study with open colectomy. Dis Colon Rectum. 2005;48(5):975–81.PubMedCrossRefGoogle Scholar
  35. 35.
    Myers E, Hurley M, O’Sullivan GC, Kavanagh D, Wilson I, Winter DC. Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008;95(1):97–101.PubMedCrossRefGoogle Scholar
  36. 36.
    Swank HA, Vermuelen J, Lange JF, Mulder IM, van der Hoeven JA, Stassen LP, et al. The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitis and Hartmann’s procedure or resection with primary anastomosis for purulent or faecal peritonitis in perforated diverticulitis (NTR2037). BMC Surg. 2010;10:29.PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Thornell A, Angente E, Gonzales E, Heath J, Jess P, Läckberg Z, et al. Treatment of acute diverticulitis laparoscopic lavage vs resection (DILALA): study protocol for a randomized controlled trial. Trials. 2011;12:186.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Koh FH, Tan KK, Tsang CB, Koh DC. Laparoscopic versus an open colectomy in an emergency setting: a case-controlled study. Ann Coloproctol. 2013;29(1):12–6.PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    McCormick JT, Simmang CL. Reoperation following minimally invasive surgery: are the “rules” different? Clin Colon Rectal Surg. 2006;19(4):217–22.PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Gersin KS, Heniford BT, Arca MJ, Ponsky JL. Alternative site entry for laparoscopy in patients with previous abdominal surgery. J Laparoendosc Adv Surg Tech A. 1998;8(3):125–30.PubMedCrossRefGoogle Scholar
  41. 41.
    Contant CM, Hop WC, van’t Sant HP, Oostvogel HJ, Smeets HJ, Stassen LP, et al. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial. Lancet. 2007;370(9605):2112–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Guenaga KK, Matos D, Wille-Jørgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev. 2011;(9):CD001544.Google Scholar
  43. 43.
    Holte K, Nielsen KG, Madsen JL, Kehlet H. Physiologic effects of bowel preparation. Dis Colon Rectum. 2004;47(8):1397–402.PubMedCrossRefGoogle Scholar
  44. 44.
    Society of American Gastrointestinal Endoscopic Surgeons (SAGES). SAGES evidence-based guidelines for laparoscopic resection of curable colon and rectal cancer. Los Angeles, CA: Society of American Gastrointestinal Endoscopic Surgeons (SAGES); 2012.Google Scholar
  45. 45.
    Ljungqvist O, Søreide E. Preoperative fasting. Br J Surg. 2003;90(4):400–6.PubMedCrossRefGoogle Scholar
  46. 46.
    Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologists Task Force on Preoperative Fasting. Anesthesiology. 1999;90(3):896–905.Google Scholar
  47. 47.
    Kong MF, Horowitz M. Diabetic gastroparesis. Diabet Med. 2005;22:13.PubMedCrossRefGoogle Scholar
  48. 48.
    Beretvas RI, Ponsky J. Endoscopic marking: an adjunct to laparoscopic gastrointestinal surgery. Surg Endosc. 2001;15(10):1202–3.PubMedCrossRefGoogle Scholar
  49. 49.
    Kim SH, Milsom JW, Church JM, et al. Perioperative tumor localization for laparoscopic colorectal surgery. Surg Endosc. 1997;11(10):1013–6.PubMedCrossRefGoogle Scholar
  50. 50.
    Conaghan PJ, Maxwell-Armstrong CA, Garrioch MV, Hong L, Acheson AG. Leaving a mark: the frequency and accuracy of tattooing prior to laparoscopic colorectal surgery. Colorectal Dis. 2011;13(1):1184–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Hyman N, Waye JD. Endoscopic four quadrant tattoo for the identification of colonic lesions at surgery. Gastrointest Endosc. 1991;37(1):56–8.PubMedCrossRefGoogle Scholar
  52. 52.
    Bass EM, Del Pino A, Tan A, Pearl RK, Orsay CP, Abcarian H. Does preoperative stoma marking and education by the enterostomal therapist affect outcome? Dis Colon Rectum. 1997;40(4):440–2.PubMedCrossRefGoogle Scholar
  53. 53.
    Randall J, Lord B, Fulham J, Soin B. Parastomal hernias as the predominant stoma complication after laparoscopic colorectal surgery. Surg Laparosc Endosc Percutan Tech. 2012;22(5):420–3.PubMedCrossRefGoogle Scholar
  54. 54.
    Axelrod L. Perioperative management of patients treated with glucocorticoids. Endocrinol Metab Clin North Am. 2003;32(2):367–83.PubMedCrossRefGoogle Scholar
  55. 55.
    Marik PE, Varon J. Requirement of perioperative stress doses of corticosteroids: a systematic review of the literature. Arch Surg. 2008;143(12):1222–6.PubMedCrossRefGoogle Scholar
  56. 56.
    Zaghiyan KN, Murrell Z, Melmed GY, Fleshner PR. High-dose perioperative corticosteroids in steroid-treated patients undergoing major colorectal surgery: necessary or overkill? Am J Surg. 2012;204(4):481–6.PubMedCrossRefGoogle Scholar
  57. 57.
    Bratzler DW, Houk PM, Surgical Infection Prevention Guidelines Writers Working Group. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis. 2004;38(12):1706–15.PubMedCrossRefGoogle Scholar
  58. 58.
    Nichols RL, Broido P, Condon RE, Gorbach SL, Nyhus LM. Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery. Ann Surg. 1973;178(4):453–62.PubMedCentralPubMedCrossRefGoogle Scholar
  59. 59.
    Cannon JA, Altom LK, Deierhoi RJ, Morris M, Richman JS, Vick CC, et al. Preoperative oral antibiotics reduce surgical site infection following elective colorectal resections. Dis Colon Rectum. 2012;55(11):1160–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Englesbe MJ, Brooks L, Kubus J, Luchtefeld M, Lynch J, Senagore A, et al. A statewide assessment of surgical site infection following colectomy: the role of oral antibiotics. Ann Surg. 2010;252(3):514–9.PubMedCentralPubMedGoogle Scholar
  61. 61.
    Marret E, Remy C, Bonnet F, Postoperative Pain Forum Group. Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery. Br J Surg. 2007;94(6):665–73.PubMedCrossRefGoogle Scholar
  62. 62.
    Levy BF, Scott MJ, Fawcett W, Fry C, Rockall TA. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery. Br J Surg. 2011;98(8):1068–78.PubMedCrossRefGoogle Scholar
  63. 63.
    Tekkis PP, Senagore AJ, Delaney CP. Conversion rates in laparoscopic colorectal surgery. Surg Endosc. 2005;19(1):47–54.PubMedCrossRefGoogle Scholar
  64. 64.
    Palaniappa NC, Telem DA, Ranasinghe NE, Divino CM. Incidence of iatrogenic ureteral injury after laparoscopic colectomy. Arch Surg. 2012;147(3):267–71.PubMedCrossRefGoogle Scholar
  65. 65.
    Ott DE. Laparoscopic hypothermia. J Laparoendosc Surg. 1991;1(3):127–31.PubMedCrossRefGoogle Scholar
  66. 66.
    Birch DW, Manouchehri N, Shi X, Jadi G, Karmali S. Heated CO2 with or without humidification of minimally invasive abdominal surgery. Cochrane Database Syst Rev. 2011:CD007821.Google Scholar
  67. 67.
    Rauh R, Hemmerling TM, Rist M, Jacobi KE. Influence of pneumoperitoneum and patient positioning on respiratory system compliance. J Clin Anesth. 2001;13(5):361–5.PubMedCrossRefGoogle Scholar
  68. 68.
    Barker L. Positioning on the operating table. Update Anaesth. 2002;15:1–6.Google Scholar
  69. 69.
    Alizadeh K, Hyman N. Venous thromboembolism prophylaxis in colorectal surgery. Surg Technol Int. 2005;14:165–70.PubMedGoogle Scholar
  70. 70.
    Nguyen NT, Cronan M, Braley S, Rivers R, Wolfe BM. Duplex ultrasound assessment of femoral venous flow during laparoscopic and open gastric bypass. Surg Endosc. 2003;17(2):285–90.PubMedCrossRefGoogle Scholar
  71. 71.
    Stahl TJ, Gregorcyk SG, Hyman NH, Buie WD, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the prevention of venous thrombosis. Dis Colon Rectum. 2006;49(10):1477–83.PubMedCrossRefGoogle Scholar
  72. 72.
    Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 Suppl):338S–400.PubMedCrossRefGoogle Scholar
  73. 73.
    Benoist S, Panis Y, Denet C, Mauvais F, Mariani P, Valleur P. Optimal duration of urinary drainage after rectal resection: a randomized controlled trial. Surgery. 1999;125(2):135–41.PubMedCrossRefGoogle Scholar
  74. 74.
    Delacroix Jr SE, Winters JC. Voiding dysfunction after pelvic colorectal surgery. Clin Colon Rectal Surg. 2010;23(2):119–27.PubMedCentralPubMedCrossRefGoogle Scholar
  75. 75.
    Kin C, Rhoads KF, Jalali M, Shelton AA, Welton ML. Predictors of postoperative urinary retention after colorectal surgery. Dis Colon Rectum. 2013;56(6):738–46.PubMedCrossRefGoogle Scholar
  76. 76.
    Bothwell WN, Bleicher RJ, Dent TL. Prophylactic ureteral catheterization in colon surgery. A five-year review. Dis Colon Rectum. 1994;37(4):330–4.PubMedCrossRefGoogle Scholar
  77. 77.
    Chahin F, Dwivedi AJ, Paramesh A, Chau W, Agrawal S, Chahin C, et al. The implications of lighted ureteral stenting in laparoscopic colectomy. JSLS. 2002;6(1):49–52.PubMedCentralPubMedGoogle Scholar
  78. 78.
    Ibrahim AA, Abrego D, Issiah IA, Smith DW. Is post-operative proximal decompression a necessary complement to elective colon resection? South Med J. 1977;70(9):1070–1.PubMedCrossRefGoogle Scholar
  79. 79.
    Nelson R, Edwards S, Tse B. Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database Syst Rev. 2007;(3):CD004929.Google Scholar
  80. 80.
    Trencheva K, Dhar P, Sonoda T, Lee S, Samuels J, Stein B, et al. Physiologic effects of simultaneous carbon dioxide insufflation by laparoscopy and colonoscopy: prospective evaluation. Surg Endosc. 2011;25(10):3279–85.PubMedCrossRefGoogle Scholar
  81. 81.
    Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) group recommendations. Arch Surg. 2009;144(10):961–9.PubMedCrossRefGoogle Scholar
  82. 82.
    History of the ERAS Society. http://www.erassociety.org/index.php/about-us/history. Accessed 29 May 2013.

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Colorectal Surgery, King’s College HospitalUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Section of Colon and Rectal Surgery, Division of General and Oncologic Surgery, Department of SurgeryUniversity of Maryland School of MedicineBaltimoreUSA

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