Health Rsks Continue Well After The Surgery Is Over
Post-Surgery Health Risks
Even when all goes well, surgery patients may carry an increased risk of cardiovascular disease and possibly cancer for weeks or even years, say physician-scientists studying the unintended effects of surgery.
"The first insight we take away from this is that when bad things happen down the road, months, maybe even years later, that we cannot, as we have in the past, just attribute it to the natural course of illness," says Dr. Steffen E. Meiler, anesthesiologist and vice chair for research in the Medical College of Georgia Department of Anesthesiology and Perioperative Medicine. "We have to start taking responsibility for some of it, certainly not all of it."
That requires more basic science and human studies to understand the mechanisms underlying ill effects and a concerted effort by all members of the health care team to avoid them, says Dr. Meiler. He talked on this topic at the 53rd Annual Meeting of the Japanese Society of Anesthesiologists June 1-3 and is guest editor of the June issue of Anesthesiology Clinics of North America devoted to the matter.
A few studies have been done across the broad spectrum of the topic, including whether short-term surgical complications, such as infections or pulmonary problems, predict an increase in long-term complications and whether mutations in genes involved in inflammation result in higher stroke rates after cardiopulmonary bypass surgery.
These studies are providing mounting evidence that there are short- and long-term increased risks, particularly for surgery patients with serious underlying disease, says Dr. Meiler.
Changes in the immune response that can result from surgery are a major player.
"The inflammatory response to surgery, for the most part, is a very good thing. We need it to protect ourselves against infection," he explains. "We need it to heal the surgical wound properly. But if you are in a high-risk group, if you are not generally healthy except for your specific surgical indication, then that protective inflammatory process may also stir up trouble."
Inflammation is a player in most major diseases, from cardiovascular disease to cancer. A heart patient, for example, already has chronic inflammation and the coronary bypass surgery he needs, ironically, may accelerate it. "It is