Background Surgical resection is the gold standard treatment for the management of early-stage lung cancer. Several modifiable factors may significantly influence postoperative morbidity and mortality. We examined the outcomes of patients following lung resection based upon preoperative smoking status to quantify the impact on postoperative outcomes.

Methods Data from consecutive lung resections from January 1, 2012 to June 11, 2021 were included. Biopsies for interstitial lung disease and resections for emphysematous lung or bullae were excluded. Patients were divided into three cohorts: current smokers (those who smoked within 4 weeks of surgery), ex-smokers (those who stopped smoking prior to 4 weeks leading up to surgery), and nonsmokers (those who have never smoked). Patient's preoperative variables, postoperative complications, length of stay, and mortality were examined.

Results A total of 2,426 patients were included in the study. A total of 502 patients (20.7%) were current smokers, 1,445 (59.6%) were ex-smokers and 479 patients (19.7%) nonsmokers. Of those smoking immediately prior to surgery 36.9% developed postoperative complications. Lower respiratory tract infections (18.1%) and prolonged air leak (17.1%), in particular, were significant higher in smokers. 90-day mortality (5.8%) was higher in the current smokers when compared with ex- and nonsmokers (5.3 and 1%, respectively). Median length of hospital stay, readmissions, and cost of hospital stay was also higher in the current smoker cohort.

Conclusion Smoking immediately prior to surgery is associated with an increase in morbidity, mortality, and length of stay. Not only does this have a significant individual impact, but it is also associated with a significant financial burden to the National Health Service.

背景 手术切除是治疗早期肺癌的金标准治疗方法。一些可改变的因素可能会显着影响术后发病率和死亡率。我们根据术前吸烟状况检查了肺切除术后患者的结局，以量化对术后结局的影响。

方法 纳入2012年1月1日至2021年6月11日连续肺切除术的数据。间质性肺疾病的活检和肺气肿或肺大泡的切除被排除在外。患者被分为三组：当前吸烟者（手术后 4 周内吸烟的人）、戒烟者（手术前 4 周之前停止吸烟的人）和不吸烟者（从未吸烟的人）。检查患者的术前变量、术后并发症、住院时间和死亡率。

结果 共有 2,426 名患者纳入研究。共有 502 名患者 (20.7%) 为当前吸烟者，1,445 名患者 (59.6%) 为戒烟者，479 名患者 (19.7%) 为非吸烟者。在术前吸烟的患者中，36.9% 出现术后并发症。尤其是吸烟者的下呼吸道感染（18.1%）和长时间漏气（17.1%）显着较高。与戒烟者和不吸烟者（分别为 5.3% 和 1%）相比，当前吸烟者的 90 天死亡率（5.8%）更高。当前吸烟者队列的中位住院时间、再入院时间和住院费用也较高。

结论 术前吸烟与发病率、死亡率和住院时间的增加有关。这不仅对个人产生重大影响，而且还给国家医疗服务体系带来巨大的财务负担。