How tobacco smoking influences surgical interventions effectiveness (review)

Abstract

Tobacco smoking not only leads to the development of diseases of organs and systems of the body, but also worsens the results of treatment, including surgical interventions. Objective: analysis of data on the results of surgical interventions depending on the status of smoking to determine the factors that contribute to/hinder smoking cessation in the perioperative period, the possibilities of providing assistance in quitting tobacco consumption. Materials and methods. A search and analysis of studies in the MEDLINE, Embase, Cochrane CENTRAL, CINAHL and PsycINFO databases was conducted. Results. Increased risks of complications after surgery in smoking patients have been proven in numerous studies: smokers had a 1.38 (95% CI, 1.11–1.72) times higher risk of death than those who had never smoked. They were also more likely to be diagnosed with pneumonia (OR 2.09), require unplanned intubation (OR 1.87) and mechanical ventilation (OR 1.53), and more often had cardiac arrest (OR 1.57), myocardial infarction (OR 1.80), stroke (OR 1.73), postoperative infections (OR 1.42), and sepsis (OR 1.30). Multivariate analysis revealed factors that reduce the risk of postoperative complications: preoperative cessation of TC two or more months before surgery, male gender, histological type and size of the tumor, concomitant cardiovascular and respiratory diseases. The main obstacles to cessation of TC in the perioperative period were: lack of time doctors and medical personnel can allocate to the issue, lack of knowledge of methods of assistance in cessation of TC and treatment of NZ. Conclusion. Smoking worsens the results of surgical interventions. The optimal period for quitting smoking is considered to be a period of 4 weeks or more, while the effectiveness of cessation is influenced by the recommendations of the attending physician and the appointment of treatment, referral to services for assistance in quitting smoking.