Intestinal Obstruction ; Preoperative Care

Introduction: Preanesthetic evaluation is a basic element of anesthesia care which aims to reduce the risks associated with anesthesia and increase quality of perioperative care. As part of the preanesthetic evaluation, questionnaires allow the anesthesiologist to quickly review a structured list and focus on pertinent findings thus ensuring a more focused evaluation. The objective of this study is to develop a self-administered preoperative assessment questionnaire in Filipinos that can be used for patients scheduled to undergo anesthesia and to determine if the questionnaire can help in risk stratification of these patients. Methods: Adult patients undergoing anesthesia were asked to fill up a 24-item questionnaire written in Filipino and English that emphasized the cardiovascular, respiratory, neurologic, endocrine, gastrointestinal, hematologic, and homeostatic status of the patient. Questions were answerable by "yes", "no", or "I don't know". A "yes" was counted as two points, "no" one point, "I don't know" as 0. Scores were then added for each patient. An anesthesia resident unaware of the results of the questionnaire validated the patient's responses by doing a routine preoperative evaluation. 'Results from the two were compared. Results: Eighty-four patients were included in the study. No significant difference was noted between the results of the questionnaire and the standard preoperative form. Tweny one patients were included in the high index group because their perioperative course was marked by previously defined adverse events while the remaining 63 were in the low index group because of an unremarkable perioperative course. Mean cumulative score of patients in the high index group was significantly higher than the low index group (30.48 vs. 27.42; p<0.05, Sig). A score of 29 or higher was also found to be associated with adverse events during the perioperative period. Conclusion: This self-administered form in Filipino was comparable to the standard evaluation done by a resident and was helpful in detecting potential problem areas for patients undergoing anesthesia and surgery. (Author)
Human ; ANESTHESIA ; SURGERY ; PREOPERATIVE CARE

Humans ; Preoperative Exercise ; Preoperative Care ; Postoperative Complications/prevention & control*

BACKGROUND: Children and parents experience significant anxiety and distress during the preoperative period. This is important because preoperative anxiety in children is associated with adverse postoperative outcome. So we suggest behaviorally oriented preoperative anxiety intervention program based on the anesthesia and psychology with smartphone application, world-widely used. METHODS: A total 120 patients (aged 1-10 years old) who were scheduled for elective surgery under general anesthesia was included in this randomized controlled trial. We randomized the patients into three groups, with using intravenous (IV) midazolam sedation (M group), with using smartphone application program (S group), and with using low dose IV midazolam plus smartphone application program (SM group). And the child anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at holding area, 5 min after intervention, entrance to operating room. RESULTS: In all three groups, mYPAS after intervention were lower than the preoperative holding area (M group 52.8 +/- 11.8 vs 41.0 +/- 7.0, S group 59.2 +/- 17.6 vs 36.4 +/- 7.3, SM group 58.3 +/- 17.5 vs 26.0 +/- 3.4). A comparison of mYPAS scores between each group showed that the S group reduced anxiety lower than M group (P < 0.01), and the SM group exhibited significantly lower anxiety than the two other groups (P < 0.01). CONCLUSIONS: The preoperative preparation program using smartphone application is simple and customized by individual development that effective in the reduction of preoperative anxiety.
Anesthesia ; Anesthesia, General ; Anxiety* ; Child ; Humans ; Midazolam ; Operating Rooms ; Parents ; Preoperative Care ; Preoperative Period ; Psychology

INTRODUCTION: Prehabilitation may benefit older patients undergoing major surgeries. Currently, its efficacy has not been conclusively proven. This is a retrospective review of a multimodal prehabilitation programme. METHODS: Patients aged 65 years and above undergoing major abdominal surgery between May 2015 and December 2019 in the National University Hospital were included in our institutional programme that incorporated aspects of multimodal prehabilitation and Enhanced Recovery After Surgery concepts as 1 holistic perioperative pathway to deal with issues specific to older patients. Physical therapy, nutritional advice and psychosocial support were provided as part of prehabilitation. RESULTS: There were 335 patients in the prehabilitation cohort and 256 patients whose records were reviewed as control. No difference in postoperative length of stay ( CONCLUSION The current study found no differences in traditional surgical outcome measures with and without prehabilitation. An increase in patient mobility in the immediate postoperative period was noted with prehabilitation, as well as an association between prehabilitation and increased adherence to postoperative adjuvant therapy. Larger prospective studies will be needed to validate the findings of this retrospective review.
Humans ; Postoperative Complications/prevention & control* ; Preoperative Care ; Preoperative Exercise ; Prospective Studies ; Retrospective Studies

No abstract available.
*Drainage ; Humans ; Metals ; *Pancreatic Neoplasms ; Preoperative Care ; Stents ; Treatment Outcome

Recent advances in medical and surgical therapy were achieved during the last two decades in the management of Crohn's disease (CD). Anti-tumor necrosis factor (anti-TNF) agents are widely used worldwide. However, a significant proportion of patients still need surgical resections. The impact of previous exposure to these agents on the perioperative and postoperative outcomes is still controversial. In this critical review, we aimed to position the strategy of intentional preoperative use of anti-TNF agents in the management of CD. The indications and contraindications for this strategy are detailed, and despite scarce evidence, the possible advantages and disadvantages of the intentional use of anti-TNF agents before abdominal surgery in CD are discussed.
Crohn Disease* ; Humans ; Necrosis* ; Preoperative Care ; Tumor Necrosis Factor-alpha

For locally advanced rectal cancer, multiple disciplinary team (MDT) has been the standard care. As a part of MDT, radiotherapy (RT) plays an important role in clinical practice. With mounting clinical evidence, RT is swifted from postoperative administration to preoperative. Compared to post-operative RT, pre-operative RT increased local control rate significantly, but not in DFS and OS. Two different preoperative RT models, short-course RT and long-course chemoradiotherapy demonstrated similar local control and long-term survival. However, a better tumor regression was observed in long-course CRT. In recent year, some small sample size studies, optimized the current pre-operative RT model, such as prolonging the interval between RT and surgery and adding consolidation chemotherapy (CT) in the interval, or adding induction CT before pre-operative RT. These optimizations decreased toxicities and increased treatment compliance, then improved the prognosis to a certain extent.
Chemoradiotherapy ; Humans ; Preoperative Care ; Prognosis ; Rectal Neoplasms ; pathology ; therapy

Hepatectomy ; Humans ; Liver Neoplasms ; surgery ; Preoperative Care ; Safety

Colorectal Neoplasms ; diagnosis ; surgery ; Humans ; Neoplasm Staging ; Preoperative Care