6.) How would you evaluate this patient preoperatively?
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This patient needs colonoscopy for diagnosis of the primary lesion and to detect synchronous polyps or malignancies. Having identified a cancer by biopsy, the patient is prepared for surgery. He should have a physiological evaluation for undergoing the stress of surgery. Then an evaluation for metastatic disease includes measurement of carcinoembryonic antigen, liver function tests, and chest X-ray. A CT scan of the abdomen and pelvis is commonly performed to evaluate for hepatic metastases and to assess the extent of local involvement.
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