[Colorectal surgery in multimorbid patients].

Abstract

Colorectal surgery in multimorbid patients requires a comprehensive interdisciplinary planning of the treatment approach, from preoperative to posthospital care, in order to minimize complications and improve the patient's outcome. Therefore, the integration of the outpatient and inpatient sectors is essential as is a perioperative interdisciplinary coordinated approach. Preoperatively, all possible risks of concomitant diseases must be considered and optimized if necessary. As part of the prehabilitation, physical exercise, optimization of eating habits and psychological care contribute to a reduction in the complication rate and a shortening of the duration of hospitalization. In older patients a comprehensive geriatric assessment improves the success of the treatment. Perioperatively, interdisciplinary care of the patient is required, whereby enhanced recovery after surgery (ERAS) programs, in particular an individually adapted volume therapy and risk-based planning of the surgical procedure, have a significant influence on the outcome. Posthospital care is also initiated through postoperative management in order to ensure continued outpatient care and surgical success.