• Journal of anesthesia · Oct 2020

    Perioperative complications of abdominal surgery in smokers.

    • Yoshikazu Inoue, Takahiko Katoh, Shota Masuda, Xi Lu, Tadashi Koga, Tomohiro Sadohara, Michiaki Sadanaga, and Eiji Tanaka.
    • Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8528, Japan. yoshikazu9999jpjp@yahoo.co.jp.
    • J Anesth. 2020 Oct 1; 34 (5): 712-718.

    PurposeThis study examined the association between smoking and perioperative complications of laparoscopic abdominal surgery and whether these complications were reduced with ≥ 4 weeks of preoperative smoking cessation.MethodsA total of 555 patients who underwent gastric and colorectal cancer surgeries under general anesthesia were divided into the following groups retrospectively: 290 individuals without smoking history (NS group), 144 previous smokers (stopped smoking more than 8 weeks before surgery, PS group), and 121 current smokers (CS group) divided to two groups according to preoperative smoking cessation for < 4 (CS1, n = 76) and 4-8 weeks (CS2, n = 45).ResultsWhen compared with the NS group, postoperative hospitalization duration was significantly longer in the CS1 group (p < 0.01), whereas differences between the CS2 or PS groups and NS group were not significant. The total number of postoperative complications was higher in all groups of smoking than in NS group, independent on preoperative smoking cessation; however, suture failure was significantly more frequent only in CS1 group. Although pack-years did not significantly affect complication rates in smokers, duration of smoking cessation time in PS group was a negative predictor of postoperative complications.ConclusionProviding more than 4 weeks of smoking cessation before gastrointestinal surgery can reduce the duration of hospitalization and rate of suture failure.

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