Current Status of Preoperative Preparation for Colorectal Cancer

Abstract

Preoperative preparation for patients with colorectal cancer includes the following three purposes: to reduce postoperative complications such as surgical site infection or anastomotic leakage, to improve postoperative quality of life such as avoiding placement of an artificial anus, and to improve postoperative outcomes. The current status of these three purposes is described. Regarding treatments to reduce postoperative complications, mechanical preoperative preparation, which is not recommended by ERAS, was performed in many institutions in Japan. In contrast, chemical preoperative preparation, which is recommended by the American CDC guidelines, was performed in few institutions in Japan. The transanal ileus tube and SEMS for patients with obstructive colorectal cancer were very useful as “bridges to surgery” and also reduced the frequency of placement of an artificial anus. Preoperative chemoradiotherapy for patients with advanced rectal cancer significantly reduced local recurrence. However, the improvement of postoperative outcomes remains unclear.