Effect of Preoperative Smoking Cessation Interventions on Postoperative Complications

Mastracci, Tara M.; Carli, Franco; Finley, Richard J.; Muccio, Salvatore; Warner, David O.

doi:10.1016/j.jamcollsurg.2011.03.015

Cited by 33 publications

(15 citation statements)

References 3 publications

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“…Most of the ERAS protocol items were included in the studies. Daily smokers have an increased risk of lung infection [36] and postoperative surgical site infection [37]. Preoperative optimization, smoking cessation and refraining from drinking, implementing epidural analgesia [38], fluid management [39], and early mobilization [40] are all steps that can be taken to reduce the incidence of lung infections.…”

Section: Discussionmentioning

confidence: 99%

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

et al. 2020

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Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods: Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results: A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR = 0.50, 95%CI: 0.33 to 0.75), postoperative length of stay (MD =-2.53, 95%CI: − 3.42 to − 1.65), time until first postoperative flatus (MD =-0.64, 95%CI: − 0.84 to − 0.45) and time until first postoperative defecation (MD =-1.10, 95%CI: − 1.74 to − 0.47) in patients who received ERAS, compared to conventional care. However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P = 0.10), surgical site infection (P = 0.42), postoperative anastomotic leakage (P = 0.45), readmissions (P = 0.31) and ileus (P = 0.25). Conclusions: ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

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Section: Discussionmentioning

confidence: 99%

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

et al. 2020

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“…Our results should aid actual clinical applications, because 2 weeks may be the minimum period needed to prepare for the operation, and this can provide patients with a strong motivation to stop smoking. For patients who have difficulty with smoking cessation, nicotine replacement therapy (NRT) in parallel with active counseling is thought to be helpful for achieving better results [27].…”

Section: Discussionmentioning

confidence: 99%

Preoperative smoking cessation can reduce postoperative complications in gastric cancer surgery

et al. 2014

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Background Despite the close link between cigarette smoking and the development of gastric cancer, little is known about the effects of cigarette smoking on surgical outcomes after gastric cancer surgery. The aim of this study was to investigate whether preoperative smoking status and the duration of smoking cessation were associated with short-term surgical consequences in gastric cancer surgery. Methods Among 1,489 consecutive patients, 1,335 patients who underwent curative radical gastrectomy at the Samsung Medical Center between January and December 2009 were included in the present study. The smoking status was determined using questionnaires before surgery. Smokers were divided into four groups according to the duration of smoking cessation preoperatively (\2, 2-4, 4-8, and [8 weeks). The primary endpoint was postoperative complications (wound, lung, leakage, and bleeding); secondary endpoints were 3-year recurrence-free survival (RFS) and overall survival (OS). Results Five hundred twenty-two patients (39.1 %) were smokers. Smokers had a significantly higher overall incidence of postoperative complications than nonsmokers (12.3 vs. 5.2 %, P \ 0.001, respectively), especially in impaired wound healing, pulmonary problems, and leakage. Smokers also had more severe complications than nonsmokers. After adjusting for other risk factors, the odds ratio (95 % CI) for the development of postoperative complications in the subgroups who stopped smoking \2 weeks, 2-4, 4-8, and [8 weeks preoperatively were 3.35 (1.92-5.83), 0.99 (0.22-4.38), 2.18 (1.00-4.76), and 1.32 (0.70-2.48), respectively, compared with the nonsmokers. There were no significant differences in 3-year RFS (P = 0.884) and OS (P = 0.258) between smokers and nonsmokers. Conclusions Preoperative smoking cessation for at least 2 weeks will help to reduce the incidence of postoperative complications in gastric cancer surgery.

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“…Most of the ERAS protocol items were included in the studies. Daily smokers have an increased risk of lung infection [36] and postoperative surgical site infection [37].…”

Section: Publication Biasmentioning

confidence: 99%

The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

Huang

Zhu

Luo

et al. 2019

Preprint

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Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods : Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results : A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection ( RR =0.50, 95%CI: 0.33 to 0.75 ), postoperative length of stay ( MD =-2.53, 95%CI: -3.42 to -1.65 ) , time until first postoperative flatus ( MD =-0.64, 95%CI: -0.84 to -0.45 ) and time until first postoperative defecation ( MD =-1.10, 95%CI: -1.74 to -0.47 ) in patients who received ERAS, compared to conventional care . However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P=0.10), surgical site infection (P=0.42), postoperative anastomotic leakage (P=0.45), readmissions (P=0.31) and ileus (P =0.25). Conclusions : ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

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Effect of Preoperative Smoking Cessation Interventions on Postoperative Complications

Cited by 33 publications

References 3 publications

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

Preoperative smoking cessation can reduce postoperative complications in gastric cancer surgery

The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

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