Basic geriatric principles for colorectal surgeons: How to optimize assessment and care of older patients in the perioperative period

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
S Rostoft, M E Hamaker

Abstract

The majority of patients with colorectal cancer are older. For surgeons dealing with older patients, it is important to recognize patients that are frail and have an increased risk of complications and mortality. In this review, we will go through pre-treatment assessment, peri-operative management, as well as discharge planning and rehabilitation. This review is based on searching the literature for studies regarding colorectal cancer, frailty, cognition, patient preferences and geriatric assessment as well as the academic and clinical experience of the authors. In the pre-treatment assessment, surgeons need to consider capacity to consent, patient preferences, frailty and life-expectancy, risk of complications, and whether the patient can be optimized before surgery. Then, the patient and treatment options should be discussed at a multidisciplinary team meeting. When the patient is admitted for surgery, discharge planning should start immediately, and if complications such as delirium or falls occur, the patient should be co-managed with geriatric services. Frail older adults with colorectal cancer need a tailored approach from pre-treatment assessment until discharge after surgery, and co-management with a geriatrician is re...Continue Reading

Citations

Oct 3, 2020·International Journal of Cancer. Journal International Du Cancer·Sophie PilleronIsabelle Soerjomataram
Jan 3, 2021·Current Oncology Reports·Nicole M SaurRiccardo A Audisio
Jan 27, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Hester E HaakUNKNOWN Dutch Watch-and-Wait Consortium

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