Does short-term cessation of smoking before lung resections reduce the risk of complications?

Journal of Thoracic Disease

article

Tomoyoshi Takenaka¹  Masaki Mori¹  Fumihiro Shoji³  Tetsuzo Tagawa¹  Fumihiko Kinoshita¹  Naoki Haratake¹  Makoto Edagawa²  Koji Yamazaki³  Mitsuhiro Takenoyama⁴  Sadanori Takeo³ 

[1] Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University;Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital;Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center;Department of Thoracic Oncology, National Kyushu Cancer Center

关键词: Lung resection;    cigarette smoking;    smoking cessation;    postoperative pulmonary complications (PPCs);   

DOI  :  10.21037/jtd-20-2574

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Smoking cessation is a highly important preparation before thoracic surgery. We examined the effects of short-term smoking cessation intervention before pulmonary resection on postoperative pulmonary complications (PPCs). Methods: A retrospective analysis of prospectively collected data was performed for 753 patients who underwent curative surgical resection for thoracic malignancy at 3 institutions. Patients with a smoking history were instructed to quit smoking. After confirming smoking cessation by at least four weeks before surgery, surgical resection was performed. Subjects were classified into three groups based on their smoking status: abstainers (anyone who had stopped smoking for at least 4 weeks but less than 2 months), former smokers (anyone who had abstained from smoking for more than two months prior to surgery), and never smokers (those who had never smoked). We examined the relationship between the preoperative smoking status and PPCs. Results: Surgery was performed for 660 primary lung cancers and 93 metastatic lung tumors. The smoking statuses were classified as follows: abstainers (n=105, 14%), former smokers (n=361; 48%) and never smokers (n=287, 38%). The incidence of PPCs among abstainers, former smokers and never smokers was 15%, 8% and 6%, respectively (P=0.01). The mean duration of post-operative chest tube drainage among abstainers, former smokers and never smokers was 3.2, 2.2 and 2.2 days, respectively (P=0.04). The mean post-operative hospital stay among abstainers, former smokers and never smokers was 12.1, 10.6 and 10.2 days, respectively (P=0.07). There was no 30-day mortality in the cohort. Conclusions: Short-term smoking cessation intervention did not enough reduce the PPCs as much as in former or never smokers.

【 授权许可】

Unknown