[Stopping smoking preoperatively: the surgeon's role]

Recently a systemic review and meta-analysis of studies on preoperative smoking and postoperative complications was published. The meta-analysis showed that wound healing is better if patients do not smoke before surgery. Also, in major surgery there were fewer postoperative pulmonary complications, wound healing was better and patients who did not smoke stayed fewer days on Intensive Care. In bone surgery the consolidation process was better in non-smoking patients. We suggest that every surgeon should give well-founded and motivational advice on stopping smoking before every operation. If there is time to postpone the operation, as is the case in gastric bypass surgery for obesity, stopping smoking should generally be a conditio sine quanon for surgery. We require surgeons to be fit to operate. Likewise, for improvement of short term and long term results we should require patients to be as fit as possible to be operated on.