Abstract
Thoughtful preoperative preparation is necessary prior to performing transanal total mesorectal excision (TaTME) whether it be for benign or malignant disease. Evaluation begins with a careful history and thorough physical examination. Additionally, the patient’s entire past medical and surgical history should be reviewed along with a detailed assessment of the patient’s current medications. Several preoperative tests are necessary regardless of etiology, and stringent oncologic principles must be followed in the preoperative staging of patients with malignant disease. Irrespective of the indication for surgery, a careful preoperative risk assessment must be performed and may warrant additional testing for cardiopulmonary fitness. Routine laboratory workup and imaging should be individualized for each patient. An enhanced recovery after surgery (ERAS) protocol should be implemented in the preoperative, intraoperative, and postoperative care of the patient. Care must be taken to ensure individual patient factors are taken into consideration with utilization of each element of the pathway.
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Bhama, A.R., Althans, A.R., Steele, S.R. (2019). Perioperative Preparation and Postoperative Care Considerations. In: Atallah, S. (eds) Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME). Springer, Cham. https://doi.org/10.1007/978-3-030-11572-2_36
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