Preoperative evaluation and a risk assessment in patients undergoing abdominal surgery

Patients who undergo abdominal surgery present along a variable spectrum of health. This ranges from the healthy young patient undergoing elective hemorrhoid surgery to the octogenarian in unstable health with multiple comorbidities. Regardless of a patient's current state of health, a preoperative assessment is crucial in planning the operative approach and in recognizing the possible postoperative complications for the implementation of a proper intervention if necessary. A broad evaluation of the patient includes identifying conditions that may predispose the patient to risks and the complications not directly related to the surgical procedure. The purpose of this article is to review the preoperative assessment in patients undergoing simple to complex procedures. The article provides general guidelines for the preoperative workup, which should be individualized for each patient, and the planned procedure, with the goal of reducing the postoperative complications. Risk stratification depends on a patient's condition and the extension of the planned surgical approach. It may also help to improve the postoperative outcome. A further preoperative workup should be individualized and tailored to the complexity of each case.