Abstract
The preoperative evaluation of the patient undergoing colorectal surgery is an extremely important aspect in patient overall care. While many surgeons can perform very complex and advanced colorectal procedures, clinical outcomes will be poor if surgeons do not wisely choose patients wisely for surgery and have them properly evaluated to ensure that they are able to tolerate the intended operation. In some cases, depending on the operative risk of the patient, surgeons choose a far less invasive operation to account for the patient’s co-morbidities. For example, fecal diversion rather than an extensive resection in the obstructed patient may be best if the patient has extensive cardiac disease and will not withstand a prolonged general anesthesia. While in many medical centers it has now become the job of the Preoperative Assessment Clinic (PAC) team of nurses and anesthesiologists to ascertain cardiac and overall operative risk in addition to order the necessary tests for the patient preoperatively, it is ultimately the responsibility of the surgeon to assure that the patient undergoing the surgery is properly evaluated and counseled to have good clinical outcomes.