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.

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 like stepping on the gas pedal,” says Dr. Meiler. Studies have shown that taking drugs such as statins, used to treat high cholesterol, or beta blockers and clonidine, used for hypertension, can protect against some of this risk.

“Giving beta blockers, statins, making sure your blood sugar doesn’t rise during surgery, minimizing blood transfusions, these are all things that we have not paid enough attention to,” says Dr. Meiler.

Even body temperature is a factor. “We now have solid evidence that if patients drop their core temperatures during surgery below 36 degrees Celsius (96.8 degrees Fahrenheit), the complication rate from postoperative infections for certain surgical procedures may be as high as threefold.”

Infections and even cancer are concerns post surgically as lower body temperature, blood transfusions and apparently volatile anesthetics actually suppress the immune response.

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