Chest
Clinical InvestigationsSmoking and Timing of Cessation: Impact on Pulmonary Complications After Thoracotomy
Section snippets
Materials and Methods
Consecutive thoracic surgical patients who were > 18 years old, and were scheduled to undergo thoracotomy for the treatment of primary or secondary lung tumors at Memorial Sloan-Kettering Cancer Center between September 1999 to November 2001, were prospectively recruited. The protocol was approved by the institutional review board, and patients gave written consent. Patients were excluded from the study for undergoing a second surgery during the same hospital admission, or for undergoing
Results
Patient demographic and clinical characteristics are shown in Table 1. A total of 300 consecutive cancer patients who underwent thoracotomy for anatomical lung resection were studied. The mean age was greater among past quitters when compared to nonsmokers (p = 0.03) [Table 1]. Nonsmokers had significantly greater FEV1 values than past or recent quitters. Similarly, nonsmokers had significantly greater Dlco percent predicted values when compared to past quitters, recent quitters, or ongoing
Discussion
In contrast to previous reports,78 this prospective study showed that there was no paradoxical increase in pulmonary complications associated with stopping smoking in the 8 weeks prior to thoracic surgery in comparison to patients with continued smoking until the time of surgery. The incidence of pneumonia in nonsmokers (3%) was significantly lower than that in recent quitters (15%) or ongoing smokers (23%), but was no different than that of past quitters (10%). Independent risk factors for
References (20)
Tobacco smoking and pulmonary complications after operation
Lancet
(1944)- et al.
Reversibility of pulmonary function abnormalities in smokers
Am J Med
(1975) - et al.
Role of preoperative cessation of smoking and other factors in postoperative pulmonary complications: a blinded prospective study of coronary artery bypass patients
Mayo Clin Proc
(1989) - et al.
Preoperative smoking habits and postoperative pulmonary complications
Chest
(1998) - et al.
Relationship between the duration of the preoperative smoke-free period and the incidence of postoperative pulmonary complications after pulmonary surgery
Chest
(2001) - et al.
Preoperative prediction of pulmonary complications following thoracic surgery
Chest
(1993) - et al.
Postoperative complications after thoracic and major abdominal surgery in patients with and without obstructive lung disease
Chest
(1993) The evolving role of exercise testing prior to lung resection
Chest
(1989)- et al.
Preoperative evaluation of patients undergoing lung resection surgery
Chest
(2003) A prospective survey of the incidence of postoperative pulmonary complications
Br J Surg
(1968)
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
Support for this research came from individual departments at Memorial Sloan-Kettering Cancer Center.