Exploring the perioptome: the role of genomics in thoracic surgery and anaesthesia.
OBJECTIVE
Genetic variation almost certainly affects every aspect of a patient's perioperative experience, yet almost nothing is known of the details involved. This review introduces the concept of static and dynamic genetic variation as a determinant of outcome after thoracic surgery and discusses some of the methodological issues involved in its study. Using a systems biology approach, it explores the ways in which data from many sources may be integrated into a common model of disease risk and outcome prediction.


RESULTS
The incidence of mortality and morbidity after lung resection is unacceptably high, and has changed little in the last 20 years. New approaches to this problem are required if we are to improve outcomes after thoracic surgery.


CONCLUSIONS
Patients seem to be predisposed to respond to a surgical stimulus in heterogeneous fashion, and this may be partly explained by variability in the genetic background with which they present for surgery. Although recent pilot data suggest that this is indeed the case, much more work remains to be done before this can be confirmed.
Shaw
Andrew
A
Division of Cardiothoracic Anesthesia and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. andrew.shaw@duke.edu
D000758:Anesthesia; D015415:Biomarkers; D004247:DNA / Q000235:genetics; D015870:Gene Expression; D023281:Genomics; D006801:Humans; D049490:Systems Biology; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome
D015415:Biomarkers; D004247:DNA