Encyclopedia of Health and Medicine

278 Surgery
Surgery Risks
All operations have general as well as specific
risks. General risks include excessive bleeding,
wound INFECTION, PNEUMONIA, and death resulting
from unanticipated crisis during the operation
(such as HEART ATTACK or STROKE). Surgeon error is
also a risk for any operation.
Personal health factors that increase surgical
and anesthetic risks include cigarette smoking,
ALCOHOL use, OBESITY, DIABETES, CHRONIC OBSTRUCTIVE
PULMONARY DISEASE (COPD), HYPERTENSION (high
BLOOD PRESSURE), CYSTIC FIBROSIS, and CORONARY
ARTERY DISEASE (CAD). Numerous medications
(including herbal products, over-the-counter
products, and illicit drugs) can interfere with anesthesia,
BLOOD clotting, or HEALING.
Age alone does not increase risk for surgical
complications. However with advancing age the
likelihood of numerous health conditions
increases, many of which can remain undetected
until a stress such as anesthesia or surgery brings
them to the forefront of the person’s health picture.
Such health conditions may include type 2
diabetes, ATHEROSCLEROSIS, CAD, renal (kidney) disease,
LIVER disease, and sometimes hypertension.
POSSIBLE RISKS OF SURGERY
ANESTHESIA reaction
death
excessive bleeding during failure of the OPERATION to
or after surgery
resolve the condition
intestinal adhesions
need for BLOOD TRANSFUSION
nerve injury
outcome other than expected
PNEUMONIA
unacceptable SCAR
worsening of health
appearance
condition
wound INFECTION
Second Opinion Consultation
A second opinion is an assessment from another
specialist who provides treatment for the same
condition for which the surgeon recommends an
operation. The specialist is often another surgeon
though may practice in a different subspecialty of
surgery. For example, a person considering back
surgery as treatment for HERNIATED NUCLEUS PULPO-
SUS (“ruptured disk”) may have a surgery recommendation
from an orthopedic surgeon and seek a
second opinion from neurologist, as both specialties
treat back problems. A person may also seek a
second opinion from a specialist who is not a surgeon,
who may recommend nonsurgical treatment
options.
Because there are often numerous options for
treating a particular health problem and surgery is
inherently invasive (a treatment that enters the
body), health experts recommend a second opinion
consultation for most elective (nonemergency)
operations. People sometimes worry that seeking a
second opinion will offend the first surgeon in
some way. However, current standards of practice
support second opinions, and surgeons are themselves
often the first to recommend them. Some
health insurance plans require second opinion
consultation for certain, and sometimes all elective,
operations.
The second opinion surgeon or physician should
• be board-certified in an appropriate and relevant
specialty
• practice in a different group or facility from that
of the first surgeon
• know the consultation is for a second opinion
ELECTIVE OPERATIONS FOR WHICH HEALTH EXPERTS
URGE A SECOND OPINION CONSULTATION
adenoidectomy
cancer operations
carpal tunnel surgery
CATARACT EXTRACTION AND LENS
CHOLECYSTECTOMY
REPLACEMENT
CORONARY ARTERY BYPASS
DILATION AND CURETTAGE (D&C)
GRAFT (CABG)
HERNIA repair
hemorrhoidectomy
HYSTERECTOMY
JOINT REPLACEMENT
knee surgery
MASTECTOMY
PROSTATECTOMY
tonsillectomy
vein ligation and stripping
The surgeon or physician providing the second
opinion consultation will require medical records,
diagnostic procedure reports, laboratory test
results, and other information relevant to the condition.
The doctor will conduct a thorough examination
of the person, then discuss the findings and
his or her professional opinions about the possible
treatments. The second opinion may or may not
support the initial recommendation for the operation.
The person may choose which physician or
surgeon will provide the recommended care. A
complex health circumstance may require multiple
consultations from different specialists, in