ABSTRACT
Surgery on the lower gastrointestinal (GI) tract, colon, rectum, and anus ranges from minor to major surgery. Whether the surgical procedure is minor or major, it still requires careful anesthetic and surgical management. There are specific challenges related to each surgical procedure. In this chapter, no attempt has been made to discuss the requirements of minor and commonly used major surgical procedures because they have been considered in greater detail in the respective chapters. Over, the last decade, hospitals worldwide have been under increasing pressure to reduce in-patient length of stay. Surgical and anesthetic teams have responded by questioning long-held views on how to go about conducting operative and perioperative care. With this, they have developed new techniques and technologies with the aim of improving operative success and overall patient outcome (Chapters 5 and 6). To achieve this goal, the concept of the ‘‘fast-track’’ surgical program has been developed (Chapter 22). This has required an integrated ‘‘team-based’’ approach and involves anesthetic, paramedical, and surgical specialties working closely together. By identifying and treating factors that can lead to or exacerbate a physiological stress response, these teams have been shown to improve outcome and benefit patients, as well as reduce hospital in-patient stay (1). In this chapter, an attempt has been made to introduce these concepts (below) from a surgical perspective, considering newer modes of surgery and surgical thinking relating to the lower GI tract. Each concept has been dealt with in more detail in other chapters in this book.
