Matsuoka Katsunari, Yamada Tetsu, Matsuoka Takahisa, Nagai Shinjiro, Ueda Mitsuhiro, Miyamoto Yoshihiro
Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan.
Ann Thorac Cardiovasc Surg. 2019 Dec 20;25(6):304-310. doi: 10.5761/atcs.oa.19-00080. Epub 2019 Jul 4.
Smoking is reported to be a risk factor for postoperative complications. However, there is no consensus regarding the length of time for which patients need to give up smoking. Therefore, we examined the relationship between preoperative smoking status and postoperative complications in patients who underwent lobectomy for treatment of lung cancer.
Between January 2009 and December 2014, 1380 patients underwent lobectomy for lung cancer at our institution. After excluding patients who had undergone induction therapy, 1248 patients were enrolled in this study. We examined the relationship between postoperative complications and preoperative smoking habitation.
Among the enrolled patients, 1210 (97%) underwent video-assisted thoracoscopic lobectomy and 38 (3%) underwent lobectomy via open thoracotomy. The incidence of postoperative complications was higher in smokers than in nonsmokers, and the frequency of respiratory-related complications increased along with the number of pack-years. However, there was no relationship between the length of the preoperative smoking cessation period and the frequency of postoperative complications.
The risk of postoperative complications does not increase even if smoking is continued within 2 weeks before surgery. It seems unnecessary to delay the timing of surgery to allow patients to cease smoking, especially those scheduled for thoracoscopic surgery.
据报道,吸烟是术后并发症的一个危险因素。然而,对于患者需要戒烟的时长,目前尚无共识。因此,我们研究了接受肺癌肺叶切除术患者的术前吸烟状况与术后并发症之间的关系。
2009年1月至2014年12月期间,1380例患者在我院接受了肺癌肺叶切除术。在排除接受诱导治疗的患者后,1248例患者纳入本研究。我们研究了术后并发症与术前吸烟习惯之间的关系。
在纳入的患者中,1210例(97%)接受了电视辅助胸腔镜肺叶切除术,38例(3%)接受了开胸肺叶切除术。吸烟者术后并发症的发生率高于不吸烟者,且与吸烟包年数相关的呼吸系统并发症的发生率也随之增加。然而,术前戒烟时间长短与术后并发症的发生率之间并无关联。
即使在手术前2周内继续吸烟,术后并发症的风险也不会增加。似乎没有必要为了让患者戒烟而推迟手术时间,尤其是对于计划进行胸腔镜手术的患者。