Duration of Smoking Cessation and Postoperative Morbidity After Esophagectomy for Esophageal Cancer: How Long Should Patients Stop Smoking Before Surgery?
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- Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Yukiharu Hiyoshi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Hironobu Shigaki
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Junji Kurashige
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Yasuo Sakamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Masaaki Iwatsuki
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Takatsugu Ishimoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Keisuke Kosumi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Hidetaka Sugihara
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Kazuto Harada
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Ryuma Tokunaga
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Daisuke Izumi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
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- Masayuki Watanabe
- Department of Gastroenterological Surgery Cancer Institute Hospital of Japanese Foundation for Cancer Research 3‐8‐31 Ariake, Koto‐ku 135‐8550 Tokyo Japan
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- Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University 1‐1‐1 Honjo, Chuoku 860‐8556 Kumamoto Japan
書誌事項
- 公開日
- 2015-09-02
- 資源種別
- journal article
- 権利情報
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- http://onlinelibrary.wiley.com/termsAndConditions#vor
- http://www.springer.com/tdm
- DOI
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- 10.1007/s00268-015-3236-9
- 公開者
- Wiley
この論文をさがす
説明
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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].</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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; <jats:italic>p</jats:italic> = 0.028). Smoking cessation ≤30 days was also the independent risk factor for pneumonia (HR 2.89, 95 % CI 1.141–7.301; <jats:italic>p</jats:italic> = 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; <jats:italic>p</jats:italic> = 0.036).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>
収録刊行物
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- World Journal of Surgery
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World Journal of Surgery 40 (1), 142-147, 2015-09-02
Wiley
