Uniportal Video-assisted Thoracic Surgery Anatomical Resections - Does Previous Tobacco Exposure Adversely Influence...

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Oncology

Background:

• A significant proportion of patients undergoing lung surgery are current or former smokers, presenting with altered pulmonary anatomy and physiology.
• The impact of smoking on postoperative pulmonary complications after lung resection remains a subject of debate.
• Uniportal VATS (video-assisted thoracoscopic surgery) is an increasingly common minimally invasive approach for lung resection.

Purpose of the Study:

• To investigate the association between smoking history and the risk of postoperative complications and morbidity in patients undergoing anatomical lung resection via uniportal VATS.
• To compare outcomes between smokers and non-smokers in this specific surgical context.

Main Methods:

• Retrospective review of peri-operative data from 303 patients who underwent anatomical lung resection using single-port VATS between December 2013 and July 2018.
• Patients were stratified into two groups based on smoking history (tobacco use vs. never smoked).
• Demographic data, pre-operative lung function, length of stay (LOS), operative time, and drainage levels were analyzed and compared statistically.

Main Results:

• Patients with a history of smoking demonstrated significantly poorer pre-operative lung function compared to non-smokers (p<0.05).
• Smoking history was significantly associated with increased prolonged air leaks (p=0.025) and overall postoperative morbidity (p=0.05).
• Smokers experienced a longer in-hospital length of stay (average 7.53 days vs. 5.36 days for non-smokers; p<0.05), longer operative times, and higher drainage volumes.

Conclusions:

• A history of smoking negatively impacts morbidity in patients undergoing uniportal VATS for anatomical lung resection.
• Smoking is linked to a higher incidence of early postoperative complications and extended hospital stays.
• These findings underscore the importance of considering smoking status in preoperative risk assessment and patient counseling for lung surgery.