ABSTRACT
Pre-operative assessment and preparation is centred around assessment of the patient's physiological reserve and ability to withstand an ongoing significant increase in metabolic demand. Fluid therapy must be carefully titrated to individual patient requirements. Patients with peritoneal malignancy often suffer from other co-morbidities such as chronic obstructive pulmonary disease, obstructive sleep apnoea, hypertension, ischaemic heart disease, chronic renal insufficiency and diabetes mellitus. Anaemia is the most common cardiovascular consequence of peritoneal malignancy and should be treated pre-operatively. Poor pre-operative nutritional status is associated with longer length of stay and increased risk of postoperative complications. Hypertension, diabetes mellitus and heart failure are associated with perioperative acute kidney injury, and optimisation of these conditions is required before surgery. Development of coagulopathy is commonly seen during surgery. Maintenance of anaesthesia with volatile anaesthetic agents or total intravenous anaesthesia and muscle relaxants is required.
