Table 1.

Components of perioperative care

Timing	Item
Preoperative	General medical optimisation and counselling Nutritional support in significantly malnourished patients Normal diet until midnight No oral bowel preparation Preanesthetic medication without long-acting sedatives Anti-thrombotic prophylaxis (LMWH and mechanical measures) Antimicrobial prophylaxis 30–60 min before skin incision
Intraoperative	Combination of mid-thoracic epidural analgesia and general anesthesia Prophylaxis of hypothermia by using cutaneous warming Avoidance of salt and water overload Midline incision of a length sufficient to ensure good exposure One or two abdominal drains routinely placed Naso-jejunal feeding tube in malnourished patients No nasogastric intubation Patients transferred to anesthesia recovery room
Postoperative	Epidural analgesia combined with intravenous analgesia Pharmacological prophylaxis of postoperative nausea and vomiting Transurethral catheters removed on POD 1 or 2 unless otherwise indicated Naso-jejunal tube feeding in malnourished patients Anti-thrombotic prophylaxis (LMWH) continued until discharge Drain removal on POD 4 to 5 unless otherwise indicated Early mobilization starting on POD 1