Takenaka Tomoyoshi, Shoji Fumihiro, Tagawa Tetsuzo, Kinoshita Fumihiko, Haratake Naoki, Edagawa Makoto, Yamazaki Koji, Takenoyama Mitsuhiro, Takeo Sadanori, Mori Masaki
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
J Thorac Dis. 2020 Dec;12(12):7127-7134. doi: 10.21037/jtd-20-2574.
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).
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.
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.
Short-term smoking cessation intervention did not enough reduce the PPCs as much as in former or never smokers.
戒烟是胸外科手术前极为重要的准备工作。我们研究了肺切除术前短期戒烟干预对术后肺部并发症（PPCs）的影响。
对3家机构753例行胸部恶性肿瘤根治性手术切除的患者进行前瞻性收集数据的回顾性分析。有吸烟史的患者被要求戒烟。在确认术前至少四周戒烟后，进行手术切除。根据吸烟状况将受试者分为三组：戒烟者（任何已戒烟至少4周但少于2个月的人）、既往吸烟者（任何在手术前已戒烟超过两个月的人）和从不吸烟者（从未吸烟的人）。我们研究了术前吸烟状况与PPCs之间的关系。
对660例原发性肺癌和93例转移性肺肿瘤进行了手术。吸烟状况分类如下：戒烟者（n = 105，14%）、既往吸烟者（n = 361；48%）和从不吸烟者（n = 287，38%）。戒烟者、既往吸烟者和从不吸烟者中PPCs的发生率分别为15%、8%和6%（P = 0.01）。戒烟者、既往吸烟者和从不吸烟者术后胸腔引流管平均留置时间分别为3.2天、2.2天和2.2天（P = 0.04）。戒烟者、既往吸烟者和从不吸烟者术后平均住院时间分别为12.1天、10.6天和10.2天（P = 0.07）。该队列中无30天死亡率。
短期戒烟干预不足以像既往吸烟者或从不吸烟者那样大幅降低PPCs。
