UNIPORTAL VIDEO-ASSISTED THORACIC SURGERY ANATOMICAL RESECTIONS – DOES PREVIOUS TOBACCO EXPOSURE ADVERSELY INFLUENCE POST-OPERATIVE OUTCOMES?

Authors

  • Joana Rei Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Susana Lareiro Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Pedro Fernandes Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Miguel Guerra Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal; Faculty of Medicine of the University of Porto, Oporto, Portugal
  • José Miranda Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Luís Vouga Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal

DOI:

https://doi.org/10.48729/pjctvs.125

Abstract

A high percentage of patients presenting for lung surgery are either current or former smokers, which is typically associated with many anatomical and physiological pulmonary changes. The influence of tobacco on postoperative pulmonary complications remains controversial. The main goal of this study was to analyse the effects of smoking on the risk of post-operative complications and morbidity in patients submitted to lung resection surgery through uniportal VATS.

Peri-operative data on all cases of anatomical lung resection surgery through single-port VATS performed between December 2013 and July 2018 at three Portuguese institutions were collected and retrospectively reviewed Demographic data, diagnosis, pre-operative lung function tests, in-hospital length of stay (LOS) and intra and post-operative drainage levels were registered. Patients were divided in two groups according to tobacco exposure. Post-operative complications and morbidity were compared through statistical analysis.

We performed 313 procedures, 303 of which were evaluated in regard to outcome. Mean age at time of surgery was of 62,85 years (SD=12,24). One hundred and sixty patients (52,81%) had a history of tobacco use, while 47,19% (n=143) had never smoked. Non-smokers had significantly better lung function than smokers (p<0,05). Smoking history showed a contribution to post-operative prolonged air leaks (p=0,025) morbidity (p=0,05), 2-day longer LOS (μ=5,36 days vs. μ =7,53 days; p<0,05), longer operative times and higher intra and post-operative drainage levels.

A history of smoking during a patient’s life negatively impacts morbidity in patients submitted to uniportal VATS for anatomical lung resection, increasing early post-operative complications and prolonging in-hospital stays.

Downloads

Download data is not yet available.

References

Erhunmwunsee, L. and M.W. Onaitis, Smoking cessation and the success of lung cancer surgery. Curr Oncol Rep, 2009. 11(4): p. 269-74.

Vansteenkiste, J., et al., 2nd ESMO Consensus Conference on Lung Cancer: early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Ann Oncol, 2014. 25(8): p. 1462-74.

Berry, M.F., et al., Impact of Pulmonary Function Measurements on Long-Term Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer. Ann Thorac Surg, 2015. 100(1): p. 271-6.

Bedat, B., et al., Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience. J Thorac Dis, 2018. 10(8): p. 5023-5029.

Agostini, P.J., et al., Risk factors and short-term outcomes of postoperative pulmonary complications after VATS lobectomy. J Cardiothorac Surg, 2018. 13(1): p. 28.

Groth, S.S., et al., Impact of preoperative smoking status on postoperative complication rates and pulmonary function test results 1-year following pulmonary resection for non-small cell lung cancer. Lung Cancer, 2009. 64(3): p. 352-7.

Bosse, Y., et al., Molecular signature of smoking in human lung tissues. Cancer Res, 2012. 72(15): p. 3753-63.

Clark, K.D., et al., Cigarette smoke inhalation and lung damage in smoking volunteers. Eur Respir J, 1998. 12(2): p. 395-9.

Argintar, E., et al., The musculoskeletal effects of perioperative smoking. J Am Acad Orthop Surg, 2012. 20(6): p. 359-63.

Mizuno, Y., et al., Influence of smoking on perioperative oxidative stress after pulmonary resection. Surg Today, 2016. 46(2): p. 183-7.

Soejima, K., et al., Longitudinal follow-up study of smoking-induced lung density changes by high-resolution computed tomography. Am J Respir Crit Care Med, 2000. 161(4 Pt 1): p.1264-73.

Zhao, J., et al., Smoking status and gene susceptibility play important roles in the development of chronic obstructive pulmonary disease and lung function decline: A population-based prospective study. Medicine (Baltimore), 2017. 96(25):p. e7283.

Howington, J.A., et al., Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013. 143(5 Suppl): p.e278S-e313S.

Louis, S.G., et al., Uniportal video-assisted thoracoscopic surgery (VATS) technique is associated with decreased narcotic usage over traditional VATS lobectomy. J Vis Surg, 2017. 3: p. 117.

Ismail, M., et al., Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy. J Thorac Dis, 2018. 10(Suppl 31): p. S3655-s3661.

Oh, T.K., et al., Relationship between pain outcomes and smoking history following video-assisted thoracic surgery for lobectomy: a retrospective study. J Pain Res, 2018. 11: p. 667-673.

Boffa, D.J., et al., Fewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer. J Thorac Cardiovasc Surg, 2014. 148(2): p. 637-43.

Desai, H., et al., Decreased In-Hospital Mortality after Lobectomy Using Video-assisted Thoracoscopic Surgery Compared with Open Thoracotomy. Ann Am Thorac Soc, 2017. 14(2): p.262-266.

Imperatori, A., et al., Peri-operative complications of video-assisted thoracoscopic surgery (VATS). Int J Surg, 2008. 6 Suppl 1: p. S78-81.

Sardari Nia, P., et al., Prognostic value of smoking status in operated non-small cell lung cancer. Lung Cancer, 2005. 47(3): p. 351-9.

Mason, D.P., et al., Impact of smoking cessation before resection of lung cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database study. Ann Thorac Surg, 2009. 88(2): p. 362-70; discussion 370-1.

Mediratta, N. and M. Poullis, Smoking status and 30-day mortality in patients undergoing pulmonary resections. Asian Cardiovasc Thorac Ann, 2016. 24(7): p. 663-9.

Rodriguez, M., et al., Refraining from smoking shortly before lobectomy has no influence on the risk of pulmonary complications: a case-control study on a matched population. Eur J Cardiothorac Surg, 2017. 51(3): p. 498-503.

Nakagawa, M., et al., Relationship between the duration of the preoperative smoke-free period and the incidence of postoperative pulmonary complications after pulmonary surgery. Chest, 2001. 120(3): p. 705-10.

Murakami, J., et al., Grading of Emphysema Is Indispensable for Predicting Prolonged Air Leak After Lung Lobectomy. Ann Thorac Surg, 2018. 105(4): p. 1031-1037.

Downloads

Published

26-05-2021

How to Cite

1.
Rei J, Lareiro S, Fernandes P, Guerra M, Miranda J, Vouga L. UNIPORTAL VIDEO-ASSISTED THORACIC SURGERY ANATOMICAL RESECTIONS – DOES PREVIOUS TOBACCO EXPOSURE ADVERSELY INFLUENCE POST-OPERATIVE OUTCOMES?. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 May 26 [cited 2024 Dec. 21];26(2):121-5. Available from: https://pjctvs.com/index.php/journal/article/view/125

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 4 > >>