It is important for you to discuss with the surgeon before the operation the risk of anesthesia, the risk of the surgical procedure itself and any potential complications. You should also discuss the operative mortality—usually defined as a death that occurs within 30 days of an operation—that can result either from the underlying disease or from complications that develop during the operation.
• The risk of anesthesia is related to your age, the magnitude of the operation and the presence of associated
diseases. The American Society of Anesthesiology has devised a formula to classify the status of patients,
divided into five classes. As the age or the associated diseases increase, the number of the class increases to
indicate a greater risk. Class 1, for example, is a middle-aged patient with no significant associated disease who
has a localized process requiring a limited operation. Class 3 patients have severe systemic disturbance from
other diseases, such as low pulmonary function, vascular complications or heart disease. The overall risk of
anesthesia, however, is very small.
• The operative risks vary greatly with the kind of operation performed. They are usually divided into immediate
risks (occurring within a few days or weeks of surgery) and late risks (occurring months or years after the
operation). Just as in the case of anesthesia, the immediate risks are increased by the presence of other diseases.
Bleeding is usually quoted as a common risk of surgery, but very few patients suffer much from it. The most
common immediate complications are pulmonary and usually result from earlier lung disease, a history of
smoking or the fact that postoperative pain and being in bed prevent the lungs from expanding. These
complications can be prevented or minimized by vigorous coughing, as a nurse may request, and by getting up
