Perioperative Management and Anesthesia

Typical surgical literature focuses on the description and outcomes of operative techniques for specific pathologic conditions. This issue of Clinics in Colon and Rectal Surgery entitled “Perioperative Management and Anesthesia” provides an in-depth review of those adjunct measures required for optimal patient outcome following colorectal surgery. These measures, though most surgeons would agree are important aspects of overall patient care, tend to be of lower priority as compared with the refinement or development of new surgical procedures.

The articles that follow provide the busy surgeon with the latest information, evidence, and recommendations for the patient preoperatively, operatively, and in the postoperative recovery period. This issue begins with preoperative patient evaluation and risk assessment, as well as the status of bowel preparation. Adjunct operative measures include anesthesia options, temperature control, role of supplemental oxygen, and fluid management. Facets of postoperative patient care presented are deep venous thromboembolism prophylaxis, pain control, ileus management, and potential complications specifically related to perineal surgery. Finally, the concept of “fast track” surgery is outlined as a method of incorporating all these adjunct measures into a usable plan to achieve the best possible outcome for the patient undergoing colorectal surgery.

I thank the contributors for their time and efforts to create what I hope our readers will find a practical and educational issue. I would also like to thank Dr. David Beck for the opportunity to edit this important and timely issue.