Smokers more likely to hemorrhage after throat surgery

Smokers more likely to hemorrhage after throat surgery

According to a report in the August issue of Archives of Otolaryngology - Head & Neck Surgery, patients who undergo a surgical procedure that removes excess tissue from the throat (uvulopalatopharyngoplasty or UPPP) along with a surgical tonsil-removing procedure (tonsillectomy) have an increased rate of hemorrhage (bleeding) if they are smokers. However, smokers do not have an increased rate of bleeding if they undergo tonsillectomy alone.

Tonsillectomy is a common surgical procedure that bears a substantial risk of complications. Over the years, indications for the procedure have changed, but there is still a great risk of post-operative hemorrhage.

Sean M. Demars, M.D., (Madigan Army Medical Center, Tacoma, Wash. (prior) and Bassett Army Community Hospital, Fort Wainwright, Alaska (current)) and colleagues studied 1,010 tonsillectomy patients and rates of post-operative bleeding from 2000 to 2005. The researchers also gathered data on age, sex and smoking status.

About 6.7% of patients presented hemorrhage, and smokers had a bleeding rate of 10.2% compared to a 5.4% rate experienced by non-smokers. The researchers write that the large difference was found "to be attributable to a marked increase in post-operative hemorrhage in the patients who underwent UPPP [10.9 percent in smokers vs. 3.3 percent in non-smokers]." Further, "Men who underwent tonsillectomy alone bled significantly more than women (11.2 percent and 5.4 percent, respectively)."

The authors specify that being aware of the link between post-operative hemorrhage and smokers, "May help clinicians further counsel their patients before surgery."

"Further investigation of this relationship is needed, with stratification of patients by the number of cigarettes smoked and attention to the length of time before and/or after surgery that patients refrain from smoking," they conclude.

The Effects of Smoking on the Rate of Postoperative Hemorrhage After Tonsillectomy and Uvulopalatopharyngoplasty

Sean M. Demars, MD; Wayne J. Harsha, MD; James V. Crawford, MD

Archives of Otolaryngology - Head & Neck Surgery . 134[8]: pp. 811-814.

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