Chapter 006 : Core Principles of Perioperative Care

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A 64-year-old male is found to have an 8-cm left renal mass and presents to the office for evaluation regarding laparoscopic radical nephrectomy. He has a personal history of hypertension, non–insulin-dependent diabetes, and 30-pack-year tobacco use (quit 10 years ago). He has a strong family history of heart disease in that his father died at the age of 55 from a myocardial infarction. Further questioning reveals that he does not regularly exercise but is able to walk up three flights of stairs without shortness of breath. Before surgery, to minimize the risk of complication, the patient should:

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