Integrative Approach to Laparoscopic Surgery for Colorectal Cancer

Abstract

Since the first report by Jacobs in 1991 (Jacobs et al., Surg Laparosc Endosc 1(3):144–150, 1991), laparoscopic colorectal surgery has been performed in an increasing number of cases each year worldwide. Reasons for the increasing number of patients treated with laparoscopic colorectal surgery include the minimally invasive nature of the procedure which results in decreased cytokine and hormonal response, reduced pain, improved cosmesis, earlier recovery, and shorter hospital stay. In this chapter, the perioperative care of patients who undergo laparoscopic colorectal surgery is presented and discussed focusing on areas of integrative approach. A transdisciplinary approach involving the systemic and active participation of the various medical specialty members in the preoperative preparation, risk assessment, and perioperative care of the patients is truly indispensable for achieving successful surgical treatment and obtaining a good quality of life after surgery. One of the important subjects of the transdisciplinary perioperative care is “prehabilitation in elderly patients.” This is particularly important to improve the physical fitness and maintain good nutritional and psychosocial condition in elderly patients. In general, the fast-track perioperative care programs consist of multidisciplinary approaches, including the participation of dieticians, nurses, surgeons, and anesthesiologists. Its aim is to reduce the surgical stress response and incidence of organ dysfunction and morbidities, thereby promoting faster recovery after surgery. Patients who undergo minimally invasive procedures are good candidates for fast-track (FT) perioperative care, and FT care reduces the incidence of postoperative organ dysfunction and morbidity resulting in a faster recovery after surgery. The use of transdisciplinary perioperative care involving the systemic and holistic participation of various specialty members is indispensable for achieving successful surgical treatment and obtaining good quality of life for the patients after laparoscopic colorectal surgery.