吸烟和癌症手术后的并发症:系统性审查和元分析
Clement Wong1, Siti Khadijah Binti Mohamad Asfia2, Paul S Myles3
1Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia.
JAMA network open
|March 7, 2025
概括
在癌症手术前至少四周停止吸烟可以显著降低手术后并发症的风险. 这一发现对于在吸烟患者中推迟手术的决策至关重要.
科学领域:
- 在瘤学瘤学.
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 对于吸烟的患者来说,外科癌症治疗往往会因为担心术后并发症增加而被推迟.
- 量化与最近吸烟相关的风险对于平衡手术时间和患者安全至关重要.
研究的目的:
- 调查吸烟状态,戒烟持续时间和癌症手术后并发症的发生率之间的联系.
主要方法:
- 在 Embase,CINAHL,Medline COMPLETE 和 Cochrane 图书馆 (2000-2023) 的系统文献搜索.
- 包括观察性和干预性研究,比较吸烟者与非吸烟者接受癌症手术的并发症率.
- 使用随机效应模型进行元分析,根据MOOSE指南提取数据.
主要成果:
- 在手术前4周内吸烟增加了并发症的几率,与至少4周的戒烟 (OR 1.31) 和从未吸烟 (OR 2.83) 相比.
- 在吸烟2周以内与戒烟2周至3个月之间没有发现并发症的显著差异 (OR 1.19).
- 在手术后1年内吸烟显示出更高的并发症几率,而不是至少1年停止吸烟 (OR1.13).
结论:
- 在癌症手术前至少4周戒烟与手术后并发症的减少有关.
- 需要进一步的高质量证据来确定最佳的戒烟期,并指导临床决定延迟手术.
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