[Pulmonary complications after thoracic surgery in smokers and non-smokers. A prospective study of 55 cases]

A prospective study was carried out between 1987 and 1989 at the Pneumological Department of the IRCCS-Policlinico S. Matteo in Pavia (Italy) to evaluate the incidence of postoperative pulmonary complications in smokers and non-smokers undergoing thoracic surgery for various diseases. Non-smokers were defined as those who had never smoked tobacco, while ex-smokers who had given up for over years were included in the "low consumption" group (less than 10 cigarettes/day). Out of a total of 55 cases, 75% were smokers. Complications developed in 20/55 cases (36.4%), whereas they were observed in 60% of the smokers' group. Major atelectasis developed in 8/20 (40%): 5 smokers and 3 non-smokers. Pulmonary complications were significantly higher among heavy smokers (greater than 10 cigarettes/day) than among non-smokers (p less than 0.001). The incidence of pulmonary complications in this study was thought to be satisfactory, although it could probably be further improved, given that daily postoperative chest X-rays and physical and/or pharmacological pre- and postoperative prophylaxis--in addition to continuous clinical monitoring--were performed. This strategy enabled complications to be detected early and controlled.