Long-term Outcome After Anesthesia and Surgery: Remarks on the Biology of a Newly Emerging Principle in Perioperative Care

There is a strong possibility that the risk from anesthesia and surgery carries over from the immediate perioperative period to more remote time points. This extended risk seems to influence the progression, severity, and complication rate of certain chronic illnesses. With the recognition that the perioperative process could be responsible for later adverse events comes the need to reassess existing patient safety models, because some of the risk could be preventable. In the meantime, we must strive to improve short- and long-term outcomes by expanding our efforts to reduce disease activity preoperatively, to control the surgical stress response and infection rate, and to use tissue-preserving surgical techniques.