Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial.


OBJECTIVE:To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications. SUMMARY BACKGROUND DATA:Complications are a major concern after elective surgery and smokers have an increased risk. There is insufficient evidence concerning how the duration of preoperative smoking intervention affects postoperative complications. METHODS:A randomized controlled trial, conducted between February 2004 and December 2006 at 4 university-affiliated hospitals in the Stockholm region, Sweden. The outcome assessment was blinded. The follow-up period for the primary outcome was 30 days. Eligibility criteria were active daily smokers, aged 18 to 79 years. Of the 238 patients assessed, 76 refused participating, and 117 men and women undergoing surgery for primary hernia repair, laparoscopic cholecystectomy, or a hip or knee prosthesis were enrolled. INTERVENTION:Smoking cessation therapy with individual counseling and nicotine substitution started 4 weeks before surgery and continued 4 weeks postoperatively. The control group received standard care. The main outcome measure was frequency of any postoperative complication. RESULTS:An intention-to-treat analysis showed that the overall complication rate in the control group was 41%, and in the intervention group, it was 21% (P = 0.03). Relative risk reduction for the primary outcome of any postoperative complication was 49% and number needed to treat was 5 (95% CI, 3-40). An analysis per protocol showed that abstainers had fewer complications (15%) than those who continued to smoke or only reduced smoking (35%), although this difference was not statistically significant. CONCLUSION:Perioperative smoking cessation seems to be an effective tool to reduce postoperative complications even if it is introduced as late as 4 weeks before surgery.


Ann Surg


Annals of surgery


Lindström D,Sadr Azodi O,Wladis A,Tønnesen H,Linder S,Nåsell H,Ponzer S,Adami J




Has Abstract


2008-11-01 00:00:00














  • Overcoming obstacles to resident-patient continuity of care.

    abstract:OBJECTIVE:Because continuity of care (CC) is a necessary component of resident education, this analysis was done to understand what keeps CC between residents and patients low and how it can be most effectively improved. BACKGROUND:Many authors lament low CC between residents and patients, especially in the era of dut...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Turner JP,Rodriguez HE,Daskin MS,Mehrotra S,Speicher P,DaRosa DA

    更新日期:2012-04-01 00:00:00

  • Cytology of peritoneal lavage performed during staging laparoscopy for gastrointestinal malignancies: is it useful?

    abstract:OBJECTIVE:To evaluate the potential benefit of cytology of the peritoneal lavage obtained during diagnostic laparoscopy for staging gastrointestinal (GI) malignancies. SUMMARY BACKGROUND DATA:Peritoneal lavage is a simple procedure that can be performed during laparotomy for GI tumors. Tumor cells in the lavage fluid ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Nieveen van Dijkum EJ,Sturm PD,de Wit LT,Offerhaus J,Obertop H,Gouma DJ

    更新日期:1998-12-01 00:00:00

  • Surgical management of reflux strictures of the esophagus in childhood.

    abstract::The etiology of gastroesophageal reflux (GER) in infancy is related to developmental factors, and there is a high incidence of associated conditions such as neurologic syndromes and esophageal atresia (60%). This is different from the situation in adults. Experience with 18 consecutive children with peptic esophageal ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: O'Neill JA Jr,Betts J,Ziegler MM,Schnaufer L,Bishop HC,Templeton JM

    更新日期:1982-10-01 00:00:00

  • Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a National Trauma Data Bank analysis.

    abstract:OBJECTIVE:Prehospital intravenous (IV) fluid administration is common in trauma patients, although little evidence supports this practice. We hypothesized that trauma patients who received prehospital IV fluids have higher mortality than trauma patients who did not receive IV fluids in the prehospital setting. METHODS...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Haut ER,Kalish BT,Cotton BA,Efron DT,Haider AH,Stevens KA,Kieninger AN,Cornwell EE 3rd,Chang DC

    更新日期:2011-02-01 00:00:00

  • Gastric surgery for morbid obesity. The Adelaide Study.

    abstract::The efficacy of three gastric restriction operations were compared in a prospective randomized study of 310 morbidly obese subjects. The median patient age was 34 years (range, 18 to 62 years). They were predominantly female (13:1) and had a median pre-operative weight that was 198% of their ideal weight (range, 160% ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hall JC,Watts JM,O'Brien PE,Dunstan RE,Walsh JF,Slavotinek AH,Elmslie RG

    更新日期:1990-04-01 00:00:00

  • Improving Benchmarks for Global Surgery: Nationwide Enumeration of Operations Performed in Ghana.

    abstract:OBJECTIVE:To evaluate the operation rate in Ghana and characterize it by types of procedures and hospital level. BACKGROUND:The Lancet Commission on Global Surgery recommended an annual rate of 5000 operations/100,000 people as a benchmark at which low- and middle-income countries could achieve most of the population-...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gyedu A,Stewart B,Gaskill C,Boakye G,Appiah-Denkyira E,Donkor P,Maier R,Quansah R,Mock C

    更新日期:2018-08-01 00:00:00

  • Elevated plasma transforming growth factor-beta 1 levels in breast cancer patients decrease after surgical removal of the tumor.

    abstract:OBJECTIVE:The authors determined whether untreated breast cancer patients have elevated plasma levels of transforming growth factor-beta 1 (TGF-beta 1). SUMMARY BACKGROUND DATA:Increased plasma TGF-beta 1 levels recently were found after chemotherapy in patients with advanced breast cancer. However, it currently is un...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kong FM,Anscher MS,Murase T,Abbott BD,Iglehart JD,Jirtle RL

    更新日期:1995-08-01 00:00:00

  • Thymic neuroendocrine tumors: a SEER database analysis of 160 patients.

    abstract:INTRODUCTION:Thymic neuroendocrine tumors (NETs) are uncommon but malignant tumors of the thymus gland that are usually associated with systemic symptoms due to hypersecretion of biogenic amines from metastatic lesions. Due to the limited number of studies in the literature, very little is known about progress or trend...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gaur P,Leary C,Yao JC

    更新日期:2010-06-01 00:00:00

  • Laparoscopic cholecystectomy and common bile duct stones. The utility of planned perioperative endoscopic retrograde cholangiography and sphincterotomy: experience with 63 patients.

    abstract:OBJECTIVE:Planned perioperative endoscopic retrograde cholangiography (ERC) and sphincterotomy (ES) for suspected or proven common bile duct stones (CBDS) has been attempted in 63 of 540 consecutive patients undergoing laparoscopic cholecystectomy (LC). Experience with this intervention has been studied with respect to...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Graham SM,Flowers JL,Scott TR,Bailey RW,Scovill WA,Zucker KA,Imbembo AL

    更新日期:1993-07-01 00:00:00

  • The Fifth Vital Sign: Postoperative Pain Predicts 30-day Readmissions and Subsequent Emergency Department Visits.

    abstract:OBJECTIVE:We hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. BACKGROUND:Surgical readmissions have few known modifiable predictors. Pain experienced by patients may reflect surgical complications and/or inadequate or dif...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Hernandez-Boussard T,Graham LA,Desai K,Wahl TS,Aucoin E,Richman JS,Morris MS,Itani KM,Telford GL,Hawn MT

    更新日期:2017-09-01 00:00:00

  • Proficiency of surgeons in inguinal hernia repair: effect of experience and age.

    abstract:OBJECTIVES:We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. SUMMARY BACKGROUND DATA:In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant diffe...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Neumayer LA,Gawande AA,Wang J,Giobbie-Hurder A,Itani KM,Fitzgibbons RJ Jr,Reda D,Jonasson O,CSP #456 Investigators.

    更新日期:2005-09-01 00:00:00

  • Quantification of asymmetric lung pathophysiology as a guide to the use of simultaneous independent lung ventilation in posttraumatic and septic adult respiratory distress syndrome.

    abstract::The management of impaired respiratory gas exchange in patients with nonuniform posttraumatic and septic adult respiratory distress syndrome (ARDS) contains its own therapeutic paradox, since the need for volume-controlled ventilation and PEEP in the lung with the most reduced compliance increases pulmonary barotrauma...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Siegel JH,Stoklosa JC,Borg U,Wiles CE 3rd,Sganga G,Geisler FH,Belzberg H,Wedel S,Blevins S,Goh KC

    更新日期:1985-10-01 00:00:00

  • Treatment of abdominal abscesses: comparative evaluation of operative drainage versus percutaneous catheter drainage guided by computed tomography or ultrasound.

    abstract::Computed tomography and, to a lesser extent, ultrasonography provide detailed anatomic localization of intra-abdominal abscesses that permit precise percutaneous placement of catheters large enough to effect drainage. Using routes similar to surgical approaches, the authors have used this technique as definitive thera...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Johnson WC,Gerzof SG,Robbins AH,Nabseth DC

    更新日期:1981-10-01 00:00:00

  • The ILAILL study: iloprost as adjuvant to surgery for acute ischemia of lower limbs: a randomized, placebo-controlled, double-blind study by the italian society for vascular and endovascular surgery.

    abstract:SUMMARY BACKGROUND DATA:High rate of complications has been reported following revascularization for acute limb ischemia (ALI). No adjuvant pharmacologic treatment, apart from anticoagulation and standard perioperative care, has been shown clinically effective. OBJECTIVE:Aim of this study was to evaluate the effects o...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: de Donato G,Gussoni G,de Donato G,Andreozzi GM,Bonizzoni E,Mazzone A,Odero A,Paroni G,Setacci C,Settembrini P,Veglia F,Martini R,Setacci F,Palombo D

    更新日期:2006-08-01 00:00:00

  • Use of transcutaneous oxygen sensors to titrate PEEP.

    abstract::The relationship of transcutaneous oxygen tension (PtcO2) to arterial oxygen tension (PaO2), pulmonary shunt (Qsp/Qt), mixed venous oxygen tension (PVO2), and O2 delivery was determined in patients with respiratory failure in order to explore the possible usefulness of PtcO2 to titrate the level of positive end expira...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Tremper KK,Waxman K,Shoemaker WC

    更新日期:1981-02-01 00:00:00

  • 24-hour ambulatory dual gastroduodenal pH monitoring. The role of acid in duodenal ulcer disease.

    abstract::A new system for long-term, 24-hour, ambulatory dual gastroduodenal pH monitoring is described. Eighteen patients with active duodenal ulcers and ten healthy subjects were studied. Simultaneous gastric and duodenal bulb pH were measured during fasting, the ingestion of a solid meal, and for the remainder of the 24-hou...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Eriksen CA,Sadek SA,Cuschieri A

    更新日期:1988-12-01 00:00:00

  • Management and outcome of abdominal shotgun wounds. Trauma score and the role of exploratory laparotomy.

    abstract:OBJECTIVE:The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA:It has been proposed that exploratory laparotomy may be unnecessary and even overused in a subset of patients with abdominal shotgun wounds. METHODS:Data on shotgun wound patients from Octo...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Cairns BA,Oller DW,Meyer AA,Napolitano LM,Rutledge R,Baker CC

    更新日期:1995-03-01 00:00:00

  • Weight Loss, Satiety, and the Postprandial Gut Hormone Response After Esophagectomy: A Prospective Study.

    abstract:OBJECTIVE:To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. BACKGROUND:With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety a...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Elliott JA,Docherty NG,Eckhardt HG,Doyle SL,Guinan EM,Ravi N,Reynolds JV,Roux CWL

    更新日期:2017-07-01 00:00:00

  • Bariatric Surgery in Medicare Patients: Examining Safety and Healthcare Utilization in the Disabled and Elderly.

    abstract:OBJECTIVE:To compare safety and healthcare utilization after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. SUMMARY BACKGROUND DATA:Though bariatric surgery is increasing among Medicare beneficiaries, no long-term, national studies examining comparative effectiveness between procedur...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Chao GF,Chhabra KR,Yang J,Thumma JR,Arterburn DE,Ryan AM,Telem DA,Dimick JB

    更新日期:2020-11-17 00:00:00

  • The walk-in anergic patient. How best to assess the risk of sepsis following elective surgery.

    abstract::This prospective study evaluated host resistance in a surgical population who walked into the hospital for elective surgery. Patients were stratified into Hospital Reactive (HR, n = 19) if they reacted to two or more of five recall skin test antigens and Walk-in Anergic (WA, n = 26) if they did not react to the antige...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Christou NV,Rode H,Larsen D,Loose L,Broadhead M,Meakins JL

    更新日期:1984-04-01 00:00:00

  • Impact of pancreatic head resection on direct medical costs in patients with chronic pancreatitis.

    abstract:OBJECTIVE:To quantitate disease-specific hospital-based medical costs in 34 patients with chronic pancreatitis before and after treatment by either duodenal-preserving pancreatic head resection (DPPHR) or pylorus-preserving pancreaticoduodenectomy (PPPD). SUMMARY BACKGROUND DATA:Pancreatic head resection in selected p...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Howard TJ,Jones JW,Sherman S,Fogel E,Lehman GA

    更新日期:2001-11-01 00:00:00

  • Natural History and Management of Blunt Traumatic Pseudoaneurysms of the Internal Carotid Artery: The Harborview Algorithm Based Off a 10-Year Experience.

    abstract:OBJECTIVE:To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms. BACKGROUND:The natural history and management of traumatic ICA pseudoaneurysms is controversial. METHODS:We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on h...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Morton RP,Levitt MR,Emerson S,Ghodke BV,Hallam DK,Sekhar LN,Kim LJ,Chesnut RM

    更新日期:2016-04-01 00:00:00

  • Aggressive resection of metastatic disease in selected patients with malignant gastrinoma.

    abstract::Fifteen patients with Zollinger-Ellison syndrome followed at the National Institutes of Health with extensive metastatic disease had an actuarial 5-year survival of 20%. Therefore, in 1982 a prospective study to examine the effect and feasibility of removing all gross tumor in selected patients with extensive metastat...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Norton JA,Sugarbaker PH,Doppman JL,Wesley RA,Maton PN,Gardner JD,Jensen RT

    更新日期:1986-04-01 00:00:00

  • A prospective pathologic analysis using whole-mount sections of rectal cancer following preoperative combined modality therapy: implications for sphincter preservation.

    abstract:OBJECTIVE:The aims of this study were to use a comprehensive whole-mount pathologic analysis to characterize microscopic patterns of residual disease, as well as circumferential and distal resection margins, in rectal cancer treated with preoperative CMT; and to identify clinicopathologic factors associated with residu...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Guillem JG,Chessin DB,Shia J,Suriawinata A,Riedel E,Moore HG,Minsky BD,Wong WD

    更新日期:2007-01-01 00:00:00

  • Bilateral breast cancer. Risk reduction by contralateral biopsy.

    abstract::Although survival from primary breast cancer has improved with earlier diagnosis and treatment, the management of the opposite breast is still in question. The risk factors for bilaterality are known, and preoperative mammography is occasionally helpful, but identification of early second breast cancer is very limited...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Wanebo HJ,Senofsky GM,Fechner RE,Kaiser D,Lynn S,Paradies J

    更新日期:1985-06-01 00:00:00

  • Lung vascular injury with protease infusion. Relationship to plasma fibronectin.

    abstract::Fibronectin exists in a soluble form in plasma and in an insoluble form in tissues. Plasma fibronectin can modulate phagocytic function as well as incorporate into the tissue matrix where it is believed to influence microvascular integrity and tissue repair. The temporal alterations in plasma and lung lymph fibronecti...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Cohler LF,Saba TM,Lewis EP

    更新日期:1985-08-01 00:00:00

  • Management of Five Hundred Patients With Gut Failure at a Single Center: Surgical Innovation Versus Transplantation With a Novel Predictive Model.

    abstract:OBJECTIVE(S):To define the evolving role of integrative surgical management including transplantation for patients gut failure (GF). METHODS:A total of 500 patients with total parenteral nutrition-dependent catastrophic and chronic GF were referred for surgical intervention particularly transplantation and comprised t...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Abu-Elmagd KM,Armanyous SR,Fujiki M,Parekh NR,Osman M,Scalish M,Newhouse E,Fouda Y,Lennon E,Shatnawei A,Kirby D,Steiger E,Khanna A,Radhakrishnan K,Quintini C,Hashimoto K,Barnes J,Costa G

    更新日期:2019-10-01 00:00:00

  • Optimal restraint reduces the risk of abdominal injury in children involved in motor vehicle crashes.

    abstract:BACKGROUND:The American Academy of Pediatrics has established guidelines for optimal, age-appropriate child occupant restraint. While optimal restraint has been shown to reduce the risk of injuries overall, its effect on specific types of injuries, in particular abdominal injuries, has not been demonstrated. METHODS:C...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Nance ML,Lutz N,Arbogast KB,Cornejo RA,Kallan MJ,Winston FK,Durbin DR

    更新日期:2004-01-01 00:00:00

  • The use of transcutaneous oxygen tension measurements in the diagnosis of peripheral vascular insufficiency.

    abstract::Transcutaneous tissue oxygen tension (PtcO2) was evaluated as a noninvasive diagnostic test for peripheral arterial insufficiency; PtcO2 was measured at rest, during exercise, and following exercise at three leg sites in 36 controls and 138 patients with exercise-induced leg pain. Resting foot PtcO2 differed significa...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Byrne P,Provan JL,Ameli FM,Jones DP

    更新日期:1984-08-01 00:00:00

  • Variation and Impact of Multiple Complications on Failure to Rescue After Inpatient Surgery.

    abstract:OBJECTIVE:To examine the extent to which multiple, sequential complications impacts variation in institutional postoperative mortality rates. BACKGROUND:Failure to rescue (FTR) has been proposed as an underlying factor in hospital variation in surgical mortality. However, little is currently known about hospital varia...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Massarweh NN,Anaya DA,Kougias P,Bakaeen FG,Awad SS,Berger DH

    更新日期:2017-07-01 00:00:00