ABSTRACT
Enhanced recovery is a programme of multidisciplinary care designed to minimise postoperative organ dysfunction and return the patient to normality as soon as possible. Hereditary non-polyposis colorectal cancer (HNPCC) was previously known as Lynch syndrome and is a genetic cause of colorectal cancer. It is responsible for about 2" of colorectal cancers and is inherited in an autosomal dominant fashion. For diagnosis they should either fit the Amsterdam criteria or have been genetically tested and demonstrated to have microsatelite instability (MSI) and defective mismatch repair gene (MMR). The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification and recommended that at least 12 lymph nodes be examined in patients with colon and rectal cancer to confirm the abscence of nodal involvement by tumour. A Cochrane review involving 13 RCTs and a total of over 1000 patients demonstrated that palliative chemotherapy was associated with 35" reduction in risk of death.
