Preparing for Surgery

How someone prepares in the days before an operation, both physically and mentally, can shape outcomes.

Just a few weeks of regular walking can make a difference, says thoracic surgeon Eric Grogan, MD, of the Vanderbilt-Ingram Cancer Center in Nashville, Tenn.

With a greater physical capacity, a patient increases the odds ofrecovery from surgical complications. "If I do a lung resection andsomeone gets pneumonia afterwards, they may have problems gettingthrough that if they don't have a lot of reserve," Grogan says.

And most important, smokers should kick the habit before surgery."It's not important for just lung function," says ChristopherMantyh, MD, chief of gastrointestinal and colorectal surgery forDuke University Medical Center in Durham, N.C. "Smoking cancause small vessels to constrict, which can hinder wound healingand possibly lead to higher rates of surgical site infections. Smokingis huge—a big, big deal."

Also, nutrition and weight play into surgical success and recovery.Focusing on improved nutrition can help some patients strugglingwith nausea or diarrhea associated with chemotherapy, Mantyh says."The stress of surgery will really take a lot of effort metabolically torecover," he says.

Conversely, obese patients have other challenges. For example,high glucose levels associated with diabetes can slow wound healing,Mantyh says.

While a patient can take steps to prepare physically, other typesof preparation also matter. Mantyh says patients at his hospital oftenreceive nutritional counseling and informative literature.

Helping patients, particularly those coping with the stress of cancer,to understand the scope of a surgery and the steps needed forrecovery, often receives short shrift, Mantyh says.

Building that understanding, however, is vitally important, Mantyhsays. "I think patient education, their understanding of what goeson during an operation and what their expectations are after surgeryare really, really important. So much so, I think it [influences] theiroutcome."