Preoperativ røykeslutt som prehabilitering for å forhindre postoperative pulmonære, kardiale og sår-relaterte komplikasjoner.

TITLE: Smoking cessation as prehabilitation to prevent postoperative pulmonary, cardiac, and wound-related complications. BACKGROUND: Smokers are at a higher risk of postoperative complications. Preoperative smoking cessation may be effective in decreasing this incidence. OBJECTIVE: To study the existing literature in the field and assess the effectiveness of smoking cessation as prehabilitation prior to surgery. METHODS: A systematic literature search for articles in PubMed and Cochrane Central Register of Controlled Trials (CENTRAL). Out of 6265 initial search results, 19 articles were included in the end (6 RTCs and 13 cohort studies). Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment tool were used for judging risk of bias. RESULTS: 6 studies found statistical evidence that pre-operative smoking cessation of at least 4 weeks reduced the incidence of postoperative pulmonary complications, while 7 studies did not find significant results. Similar findings were found regarding wound complications, where the number of articles were 3 and 5 respectively for the same interval of abstinence. When it comes to cardiac complications, 1 study found a significant effect of pre-operative smoking cessation (p=0.003), while one did not. CONCLUSION: Studies show that smoking cessation as early as 4 weeks prior to surgery can reduce risk of postoperative pulmonary and wound-related complications. Regarding postoperative cardiac complications, more data is needed to assess the effectiveness of pre-operative smoking cessation