European Journal of Biomedical and Pharmaceutical Sciences

IMPACT OF SMOKING ON SURGICAL OUTCOMES AND COMPLICATIONS IN COLORECTAL CANCER PATIENTS

Fadi Mahmoud Maitta*, Abedalsalam Abdullah Alsaraireh, Al-Hassan Ibrahim Salem Al-Rawashdeh, Sofyan
Hussein Khalid El-Khatib, Tasneem Ali Seif Al Deen Janeb, Abdullah Abu Anzeh, Mohammad Ahmad
Abual’anaz, Nehaya Raji Helal and Ahmad Uraiqat

ABSTRACT

Background: It is undebatable that smoking is a major risk factor for various diseases, and the leading cause of
morbidity and mortality. Colorectal cancer (CRC) patients undergoing surgical resection are under possible
complications including infections, leakage, and anastomosis. However, the effect of smoking on the postoperative
complications of CRC patients undergoing surgical resections needs further investigation. Purpose: We
aim to investigate the association between pre-operative smoking on the post-operative outcomes in a population
of CRC patients from Jordan undergoing surgical resection. In addition, we aim to investigate if the risk of postoperative
complications are linked to other demographic and clinical factors. Methods: A retrospective, singlecenter
study from King Hussien Medical Center in the period between 2016 to 2024. Patients’ information will be
recruited by accessing electronic hospital records. Demographic data will be collected for patients’ ID, national
number, age, and gender. Clinical variables will include body-mass index (BMI), smoking history (Smoker, Nonsmoker,
or Former-smoker), type of surgery (elective, or emergency), and mode of surgery (laparoscopic, or open).
Post-operative evaluation will be determined by length of hospitalization in days, and post-operative
complications. Results: We included 542 CRC patients who with a mean age of 58 years, and 58% are males.
Smoking status varied, with 24% of patients being current smokers, 72% non-smokers, and 3% ex-smokers. There
was a significant gender difference in smoking status, with 91% of smokers being male and 54% of non-smokers
being female. Postoperative complications occurred in 26.4% of patients. The mortality rate was 1.5%. There was
a trend toward higher postoperative pain in current smokers. Ever smokers had a lower rate of wound infections
compared to non-smokers (2.7% vs. 7.4%). Logistic regression revealed that males had a higher likelihood of
postoperative complications, and laparoscopic surgery was associated with better outcomes compared to open
surgery.

Keywords: Colorectal cancer, Jordan, Smoking, Colectomy, Hemicolectomy, Complications.