Canadian Health and Care Mall: Smoking and Timing of Cessation

SmokersSmoking has been found to be a risk factor for the development of postoperative complications after many types of surgery, even in the absence of underlying chronic lung disease. The relative risk of complications after surgery for smokers compared to nonsmokers has been reported to increase from 1.4-fold to 4.3-fold. Smoking cessation prior to surgery is widely encouraged, but the value of stopping only a few days to weeks prior to an operation is not known. A decrease in postoperative pulmonary complications due to smoking cessation is thought to be related to physiologic improvement in ciliary action, macrophage activity, and small airways function, as well as a decrease in sputum production, These changes can take weeks to months to occur.

Some studies have suggested that stopping smoking only a few weeks prior to surgery may lead to an unexpected or paradoxical increase in the rate of pulmonary complications, and recommendations have been made that surgery should be delayed for 8 weeks after smoking cessation.

COPDThe effect of smoking and the time of smoking cessation on postoperative pulmonary complications in patients undergoing thoracotomy for primary or secondary lung tumors is unclear. Many of these patients, particularly those with primary lung cancer, are current or past smokers, and some have COPD. Since the extent of lung resection may affect outcome, lung-sparing surgery, such as wedge resection, is often preferentially performed in those with marginal pulmonary reserve, making risk prediction difficult. Only one retrospective study has looked at patients undergoing thoracotomy for lung cancer and found that it took 5 weeks of smoking abstinence for complications in smokers to decrease to the level of ex-smokers. The complication rate was highest in those who quit smoking within 4 weeks of surgery, Since patients who are potentially capable of undergoing resection proceed to surgery as quickly as is feasible, the impact of quitting the smoking of cigarettes in the preoperative period on postoperative complications is an important issue. We undertook this prospective study to clarify the relationship of postoperative pulmonary complications to smoking history and the timing of smoking cessation in those scheduled to undergo the anatomical resection of primary or secondary lung tumors. Smoking may lead to different severe disorders. But to what – the answer may be found here on official website – Canadian Health&Care Mall.