Pre-operative care makes significant impact on the overall surgical process. With the increasing number of surgical procedures conducted in patients with advanced age and multiple medical co-morbidities, the complexity and risk of procedures are also on the rise, despite technological advancement and introduction of minimally invasive surgery. Well-managed pre-operative care can potentially reduce procedure-related or medically-related complications and positively influence post-operative recovery.
Once the surgical decision is affirmed, comprehensive pre-operative assessment should follow. No dobut the collaborations between the surgical and anaesthetic team are essential but increasingly specialists from other disciplines such as internal medicine and geriatrics are involved. However, since the surgeons hold the primary responsibility to the patients, appropriate general assessment such as the geriatric vulnerabiltiy screens or frailty scoring should be performed by surgeons before consulting colleagues from other specialties.
Risk stratification is important because of its impact on surgical decision-making and how to optimize patients pre-operatively. The availability of more accurate risk prediction could help both the care team and patients (as well as their families) in making decisions on various treatment options. Such risk predictions can be general and procedure-specific.
Patient education and communication are part of our duty of care to patients. Through appropriate risk disclosure and explanations, we can help patients set realistic expectations for the post-operative period, and address their concerns and worries. Such communication can also motivate patients to actively take part in prehabilitation programmes in preparing for the surgical procedures.
