Table 1.

Summary of recommendations

Type of cancer/stage	BMI	Peri operative		Preoperative						Intraoperative	Post-operative
		MIS recommended	Include in clinical pathway	Waiting restriction	Nutrition assessment	VLCD	VLCD duration	VLCD Type	Risk prediction scores	Optical trocar/ICG/Long instruments/bariatric theatre standards and tables	Revise dosing regimen for all drugs	OSA and HDU considerations	Surveillance
Colon
Stage I	≥ 30 k/m2	Yes	Yes	No	CT body composition	If no sarcopenia	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Stage II	≥ 30 k/m2	Not in T4	Yes	No	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Stage III	≥ 30 k/m2	Not in T4	Yes	No	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Stage IV	≥ 30 k/m2	Not in T4 Only if respectable liver and/or lung metastasis	Yes if operable?	No if operable	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Rectum
Stage I	≥ 30 k/m2	No unless experienced in Lap. TME or high-risk tumours (i.e., positive margin)	Yes	Yes	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Stage II	≥ 30 k/m2	No unless experienced in Lap. TME or high-risk tumours (i.e., positive margin	Yes	Yes	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Stage III	≥ 30 k/m2	Not in T4 No unless experienced in Lap. TME or high-risk tumours (i.e., positive margin	Yes	Yes	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes
Stage IV	≥ 30 k/m2	Not T4? If respectable lung and/or liver metastasis post chemoradiotherapy	Yes If operable	Yes if operable	CT body composition	If no sarcopenia ± in open	1–2 weeks		Yes	Yes	Yes	Yes	Yes

MIS minimally invasive surgery, TME total mesorectal excision, CT computed tomography, VLCD very low calorie diet