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Preoperative evaluation for gynecologic surgery: a guide to judicious, evidence-based testing
Jessica Shields1, Andrew Lupo, Teresa Walsh
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Current Opinion in Obstetrics & Gynecology
|June 12, 2018
Summary
Routine preoperative laboratory and diagnostic testing for elective gynecologic surgery is often unnecessary and overutilized. A targeted approach based on individual patient risk stratification is recommended to optimize care and reduce costs.
Area of Science:
- Gynecologic Surgery
- Preoperative Assessment
- Diagnostic Testing
Background:
- Preoperative testing is standard in surgical planning but frequently overused.
- Existing literature indicates that routine laboratory and diagnostic studies for elective surgery are excessive.
Purpose of the Study:
- To summarize current literature on preoperative testing in gynecologic surgery.
- To provide guidance for gynecologists on appropriate preoperative testing for elective procedures.
Main Methods:
- Literature review and synthesis of existing publications.
- Analysis of the utility and impact of preoperative tests on surgical planning and outcomes.
Main Results:
- The frequency of abnormal preoperative test results is high, but their impact on surgical planning and patient outcomes is minimal.
- Routine testing is deemed unnecessary and excessive for many elective surgeries.
Conclusions:
- Preoperative evaluation should prioritize thorough history and physical examination.
- Implementing protocols for risk-stratified preoperative testing can decrease unnecessary procedures without compromising patient safety or surgical outcomes.
- Shifting from routine testing to individualized risk assessment aligns with value-based care principles.
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