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Preoperative Medical Optimization

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Enhanced Recovery After Surgery

Abstract

Over the last decade, preoperative testing centers have become the cornerstone for preoperative evaluation of patients presenting for elective surgery. This was aimed to provide appropriate information about comorbidities to the surgeon and anesthesiologist in a timely manner and to reduce last-minute cancelations due to missing reports or the need for further testing. These clinics have oftentimes limited their activity to collecting data on patients but have fallen short on analyzing and optimizing patients whenever possible. With the expansion of the enhanced recovery after surgery (ERAS) principle to include preoperative optimization of medical comorbidities and improving the patients’ resilience to surgical and perioperative stress through improving cardiovascular fitness, pulmonary reserve, nutrition, and psychological strength, early experience shows encouraging data on patients becoming surgically fit before undergoing oftentimes invasive and high-risk procedures. This chapter aims at summarizing current evidence for the utility of assessing the perioperative risk and preoperative optimization of modifiable medical comorbidities before elective surgery.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Matthias Stopfkuchen-Evans

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  1. Matthias Stopfkuchen-Evans
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Correspondence to Matthias Stopfkuchen-Evans .

Editor information

Editors and Affiliations

  1. Department of Surgery, Örebro University Hospital, Örebro, Sweden

    Olle Ljungqvist

  2. Yeovil District Hospital NHS Foundation Trust Higher Kingston, Yeovil, Somerset, UK

    Nader K. Francis

  3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s, Hospital Harvard Medical School, Boston, MA, USA

    Richard D. Urman

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Stopfkuchen-Evans, M. (2020). Preoperative Medical Optimization. In: Ljungqvist, O., Francis, N., Urman, R. (eds) Enhanced Recovery After Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-33443-7_9

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  • DOI: https://doi.org/10.1007/978-3-030-33443-7_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33442-0

  • Online ISBN: 978-3-030-33443-7

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