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Does getting smokers to stop smoking before lung resections reduce their risk?
Mahvash Zaman1, Haris Bilal, Sarah Mahmood
1School of Medicine, University of Liverpool, Liverpool, UK.
Interactive Cardiovascular and Thoracic Surgery
|December 14, 2011
Summary
Quitting smoking before lung surgery significantly lowers the risk of post-operative pulmonary complications (PPCs). A pre-operative smoke-free period, especially over 10 weeks, yields complication rates comparable to never-smokers.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Evidence-Based Medicine
Background:
- Investigating the association between smoking cessation timing and major pulmonary morbidity after lung resection.
- Reviewing 49 papers to identify the best evidence for clinical questions.
Observation:
- Most studies indicate smoking abstinence reduces post-operative pulmonary complications (PPCs).
- PPCs include pneumonia, respiratory distress, atelectasis, air leakage, bronchopleural fistula, and re-intubation.
- Evidence suggests a reduced risk of PPCs with a longer interval since smoking cessation.
Findings:
- Two studies recommend at least 4 weeks of smoking abstinence before surgery to reduce major pulmonary events.
- A pre-operative smoke-free period exceeding 10 weeks results in complication rates similar to never-smokers.
- Smoking cessation demonstrably reduces the risk of PPCs.
Implications:
- All patients undergoing lung resection should be advised to stop smoking.
- Counseling patients on smoking cessation pre-operatively is crucial for reducing surgical risks.
- Optimizing pre-operative smoking cessation can significantly improve patient outcomes in thoracic surgery.
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