Smoking has long been linked with slower recovery in general from
injuries and surgeries, and now a new study finds that smokers face more
complications and higher chances of death following major surgery for
colorectal cancers and other diseases. "We wanted to see if smoking has a
specific effect on these patients... and really wanted to know if patients who
stopped smoking had better results," said lead author Dr. Abhiram Sharma,
who was at the University of Rochester in New York during the study.
An ash tray with cigarette butts is pictured in Hinzenbach (Lisi Niesner Reuters, REUTERS /February 5, 2012)
Smoking constricts the flow of blood throughout the body and is thought
to prevent oxygen from getting to tissues that are trying to heal, according to
the authors.
In September, a review of surgeries to repair knee ligaments found that
smokers tended to have worse outcomes, including not being able to get back
full knee function. For the new report,
published in the Annals of Surgery, Sharma and his colleagues studied patients
included in a nationally representative database of U.S. surgeries between 2005
and 2010.
Overall, 47,574 patients were included in the analysis. All had part of
their colon or rectum removed, a surgery known as a colorectal resection,
either because of cancer, diverticular disease or inflammatory bowel disease. About
60 percent of the patients had never smoked, 19 percent were former smokers and
20 percent were current smokers.
The researchers looked at the 30 days after surgery to see how many
patients in each group suffered either a major complication - such as severe
infection, heart or breathing problems or death - or a minor complication, such
as an infection at the surgical site or in the urinary tract.
Sharma's team found that current smokers had a 30 percent greater risk
of having a major complication compared to patients who never smoked, and an 11
percent greater risk than ex-smokers. Among 9,700 current smokers, for example,
there were 1,497 major complications and 1,448 minor ones, whereas the 9,136
ex-smokers had 1,374 major and 1,386 minor complications. Never smokers, the
largest group numbering 28,738, had 3,316 major complications and 3,462 minor
ones. Current smokers were also 1.5 times as likely to die within 30 days of
surgery as never smokers.
In addition, the longer someone had smoked - that is, the greater their
number of "pack years" - the stronger their chances of complications,
the researchers note. "We were not completely surprised (by the results).
We know smoking is not good and there have been other studies that show smoking
is a problem," Sharma said.
There were, Sharma's team acknowledges, some limitations in the study. For
example, ex-smokers were defined as patients who had not smoked in at least one
year, therefore some more recent ex-smokers may have been included with current
smokers, leading the benefits of quitting to be underestimated. Nonetheless,
Sharma told Reuters Health, the results show it's never too late to stop
smoking. "The sooner the better," he said.
Source: Chicago Tribune
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