ISSN: 2577-4301
Authors: Ali AM, Naser Al-Dossari D, Naguib NN, Hussein helmy M, Ahmed Selim M, Mickae SA and Nasser M Dobal*
Background: Smoking is a risk factor for postoperative pulmonary complications following lung resection surgery in cancer patients. The respiratory system might take 6 weeks to return to normal function after general anaesthesia for major surgery. Induction of general anaesthesia can cause changes and reductions of the respiratory parameters e.g. reduction of lung volume. A recent study by Kozub found that the duration of smoking cessation had no significant influence on the frequency of postoperative pulmonary complications, and that the optimal timing for preoperative smoking cessation has not been identified. Purpose and aim: to evaluate the effect of the duration of smoking cessation pre-operatively and the incidence of postoperative pulmonary complications after general anaesthesia in patients with lung cancer coming for lung resection. Design and Methodology: a retrospective observational design using patient records as a data collection tool. The population was adult smoker patients who were coming for elective lung resection surgery under general anaesthesia in King Fahad Specialist Hospital in Dammam Saudi Arabia. A sample of 30 patients was determined based on the available number of patients who met the study inclusion criteria. A chi-square test was performed to examine the association between smoker patients who stopped smoking for 6 weeks and other smoker patients who stopped smoking for less than 6 weeks prior to surgery. Results and findings: The findings revealed that there was not statistical difference in the incidence of post-operative pulmonary complications after lung resection surgery under general anaesthesia between smoker patients who stopped smoking for more than six weeks and smoker patients who stopped smoking for less than six weeks. The Chi-square was 3.33 with a P-value of 0.07; showing no statistical significance between variables from the two groups. 100% of the smoker patients who stopped smoking for more than 6 weeks (15 patients of the study sample) had no post-operative pulmonary complications, and 20% of smoker patients who stopped smoking for less than 6 weeks (15 patients of the study sample) had a few post-operative pulmonary complications. However, this findings was not statically significant. Another chi-square test performed to find out the type of post-operative pulmonary complications occurred. The type of complications found were cough, bronchitis, bronchospasm and pneumonia. The onset of post-operative pulmonary complications was also evaluated which occurred either after 48, 50 or 72 hours in the post-operative period. Conclusion: The No association between smoker patients who stopped smoking for 6 weeks and other smoker patients who stopped smoking for less than 6 weeks on the incidence, severity, and onset of post-operative pulmonary complications. It would seem unnecessary to postpone surgery in order to allow an optimal smoking cessation period for patient coming for lung resection surgery under GA. Smoking cessation is however still strongly recommended when treating patients with lung cancer, but it would seem unnecessary to delay surgery in order to ensure an optimal cessation of smoking period. Moreover, literature is inconsistent about the optimal time for smoking cessation before surgery. Focus on preoperative patient management, anaesthesia, postoperative pain management and surgical techniques are more effective to improve pulmonary function and reduce post-operative pulmonary complications.
Keywords: Smoking; Cancer; Lung
