TY - JOUR
T1 - Duration of Smoking Cessation and Postoperative Morbidity After Esophagectomy for Esophageal Cancer
T2 - How Long Should Patients Stop Smoking Before Surgery?
AU - Yoshida, Naoya
AU - Baba, Yoshifumi
AU - Hiyoshi, Yukiharu
AU - Shigaki, Hironobu
AU - Kurashige, Junji
AU - Sakamoto, Yasuo
AU - Miyamoto, Yuji
AU - Iwatsuki, Masaaki
AU - Ishimoto, Takatsugu
AU - Kosumi, Keisuke
AU - Sugihara, Hidetaka
AU - Harada, Kazuto
AU - Tokunaga, Ryuma
AU - Izumi, Daisuke
AU - Watanabe, Masayuki
AU - Baba, Hideo
N1 - Publisher Copyright:
© 2015 Société Internationale de Chirurgie.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background: Smoking is one of the risk factors for postoperative morbidity. There were no studies on the correlation between the duration of smoking cessation and the incidence of morbidities after esophagectomy. Methods: A total of 246 patients undergoing elective esophagectomy with 2- or 3-field lymphadenectomy for esophageal cancer between April 2005 and February 2015 were retrospectively analyzed. Patients were divided into five groups according to the duration of smoking cessation [no smoking cessation (including cessation for a few days), cessation for 7-30, 31-90, ≥91 days, never smoker]. Results: Any morbidity of Clavien-Dindo classification (CDc) ≥II, pneumonia, any pulmonary morbidity, surgical site infection, cardiovascular morbidity, and severe morbidities of CDc ≥IIIb frequently occurred in patients with no smoking cessation. The incidence of pneumonia and severe morbidities decreased as the duration of smoking cessation became longer. Logistic regression analysis suggested that no smoking cessation was the independent risk factor for any pulmonary morbidity (HR 3.68, 95 % CI 1.152-11.74; p = 0.028). Smoking cessation ≤30 days was also the independent risk factor for pneumonia (HR 2.89, 95 % CI 1.141-7.301; p = 0.025). Smoking cessation ≤90 days was the independent risk factor for severe morbidities of CDc ≥IIIb (HR 2.82, 95 % CI 1.072-7.427; p = 0.036). Conclusions: Preoperative smoking cessation more than 90 days is ideal to reduce morbidities after esophagectomy. When patients with insufficient smoking cessation undergo esophagectomy, careful perioperative management is required.
AB - Background: Smoking is one of the risk factors for postoperative morbidity. There were no studies on the correlation between the duration of smoking cessation and the incidence of morbidities after esophagectomy. Methods: A total of 246 patients undergoing elective esophagectomy with 2- or 3-field lymphadenectomy for esophageal cancer between April 2005 and February 2015 were retrospectively analyzed. Patients were divided into five groups according to the duration of smoking cessation [no smoking cessation (including cessation for a few days), cessation for 7-30, 31-90, ≥91 days, never smoker]. Results: Any morbidity of Clavien-Dindo classification (CDc) ≥II, pneumonia, any pulmonary morbidity, surgical site infection, cardiovascular morbidity, and severe morbidities of CDc ≥IIIb frequently occurred in patients with no smoking cessation. The incidence of pneumonia and severe morbidities decreased as the duration of smoking cessation became longer. Logistic regression analysis suggested that no smoking cessation was the independent risk factor for any pulmonary morbidity (HR 3.68, 95 % CI 1.152-11.74; p = 0.028). Smoking cessation ≤30 days was also the independent risk factor for pneumonia (HR 2.89, 95 % CI 1.141-7.301; p = 0.025). Smoking cessation ≤90 days was the independent risk factor for severe morbidities of CDc ≥IIIb (HR 2.82, 95 % CI 1.072-7.427; p = 0.036). Conclusions: Preoperative smoking cessation more than 90 days is ideal to reduce morbidities after esophagectomy. When patients with insufficient smoking cessation undergo esophagectomy, careful perioperative management is required.
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U2 - 10.1007/s00268-015-3236-9
DO - 10.1007/s00268-015-3236-9
M3 - Article
C2 - 26330238
AN - SCOPUS:84975743120
SN - 0364-2313
VL - 40
SP - 142
EP - 147
JO - World journal of surgery
JF - World journal of surgery
IS - 1
ER -