Department of Otolaryngology-Head and Neck Surgery, Division of General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Laryngoscope. 2012 Aug;122(8):1800-8. doi: 10.1002/lary.23308. Epub 2012 Jul 2.
OBJECTIVES/HYPOTHESIS: Cigarette smoking is the most important risk factor for head and neck cancer. Conventional wisdom suggests that smoking causes increased postoperative wound healing and systemic complications in this patient population, but it is unclear if the clinical literature supports this.
Systematic review.
The authors performed a review of the literature from 1990 to 2010 on the effect of cigarette smoking on perioperative complications in head and neck surgery.
Thirty-six articles met eligibility criteria and were reviewed; 14 focused on extirpative surgery and 22 on reconstruction. Most of the evidence was comprised of case series and small cohort studies. We reviewed local wound healing and systemic complications, and 47% of studies supported an association between smoking and complications of surgery.
Evidence from the existing clinical literature is inconclusive on an association between cigarette smoking and perioperative complications after head and neck surgery. The negative impact of smoking is suggested; however, the majority of articles had significant methodological weaknesses. Prospective study of tobacco-induced complications is needed.
目的/假设：吸烟是头颈部癌症的最重要危险因素。传统观点认为，吸烟会导致此类患者术后伤口愈合不良和全身并发症增加，但目前尚不清楚临床文献是否支持这一观点。
系统综述。
作者对 1990 年至 2010 年有关吸烟对头颈部手术围手术期并发症影响的文献进行了回顾。
36 篇文章符合入选标准并进行了回顾，其中 14 篇侧重于切除术，22 篇侧重于重建术。大部分证据为病例系列和小队列研究。我们对局部伤口愈合和全身并发症进行了综述，47%的研究支持吸烟与手术并发症之间存在关联。
现有临床文献证据尚不能确定吸烟与头颈部手术后围手术期并发症之间存在关联。吸烟的负面影响是存在的；然而，大多数文章存在明显的方法学缺陷。需要对烟草引起的并发症进行前瞻性研究。
