title: Perioperative care in gynecologic oncology.
abstract: OBJECTIVE
  To review perioperative care in gynecologic oncology with special emphasis on areas of controversy.
  
  
  RESULTS
  Major gynecologic surgery still represents the cornerstone of management among women diagnosed with gynecologic malignancies. The implementation of clinical guidelines can significantly impact perioperative morbidity and mortality. Preoperative evaluation and preparation allows the surgeon to identify patient risks and develop risk factor modification strategies decreasing delays in preparation and cost and improving patient safety. Preoperative areas of controversy include preoperative testing and evaluation, use of mechanical bowel preparation, prophylactic antibiotics, and use of anticoagulants, and the timing of postoperative feeding.
  
  
  CONCLUSIONS
  In healthy women undergoing gynecologic cancer surgery preoperative evaluation requirements will be minimal. For women with extensive comorbid conditions a more detailed evaluation will be required to decrease perioperative morbidity and mortality. Mechanical bowel preparations should not be required preoperatively. Preoperative administration of antibiotics and anticoagulants should be provided to all patients undergoing major gynecologic cancer surgery.
authors.affiliation: The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Kushnir
authors.forename: Teresa P
authors.initials: TP
authors.lastname: Díaz-Montes
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002400:Cathartics / Q000627:therapeutic use; D005248:Feeding Methods; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D054556:Venous Thromboembolism / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D002400:Cathartics