Harmful gases including carcinogens produced during transurethral resection of the prostate and vaporization

Abstract

Objective: To determine the chemical composition of surgical smoke produced during transurethral resection of the prostate (TURP) and vaporization. Methods: A total of 12 smoke samples were collected from a continuous irrigation suction drainage system to a Tenax absorber at a 0.05 L/min flow rate during TURP and vaporization. The gases were quantitatively and qualitatively analyzed by gas chromatography-mass spectrometry (GC-MS) equipped with a purge and trap sample injector. Results:The main chemical constituents of surgical smoke produced during TURP and vaporization include propylene, allene, isobutylene, 1,3-butadiene, vinyl acetylene, mecaptomethane, ethyl acetylene, diacetylene, 1-pentene, EtOH, piperylene, propenylacetylene, 1,4-pentadiene, cyclopentadiene, acrylnitrile and butyrolactone. Three of the constituents are very toxic and carcinogenic (1,3-butadiene, vinyl acetylene and acrylonitrile). The amount (mean Ϯ standard deviation) of chemical components in the 45 L of gas and room air mixture produced during TURP and vaporization were as follows: propylene, 0.80 Ϯ 0.52 mg; isobutylene, 212.85 Ϯ 75.65 mg; 1,3-butadiene, 0.93 Ϯ 0.34 mg; ethyl acetylene, 0.09 Ϯ 0.05 mg; 1-pentene, 6.75 Ϯ 1.62 mg; 1,4-pentadiene, 0.06 Ϯ 0.02 mg; and acrylonitrile, 1.62 Ϯ 1.19 mg. Conclusions: Three of the toxic gases generated during TURP and vaporization are carcinogens (1,3-butadiene, vinyl acetylene and acrylonitrile). Therefore, higher quality filter masks, smoke evacuation devices and/or smoke filters should be developed for the safety of the operating room personnel and patients during TURP and vaporization.

Composition of the electrocautery smoke: integrative literature review

“…In the studies of the third category (E4 to E14) (4,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) , several gases were identified, but the VOC were the chemical compounds present in all articles. Therefore, the predominant VOC identified and quantified were the following: benzene (4,(21)(22)28) , ethylbenzene (4,21,26,(28)(29) , toluene (4,(21)(22)(23)26,(28)(29)(30) , styrene (4,21,26,28) and butadiene (22,(24)(25)27,30) . This diversity of compounds can be justified by the different types of surgeries in which were collected smoke samples, the body mass index of different patients, and the duration, and energy of electrocautery use because these factors can alter the compounds production (23,26) , increasing the risk of occupational exposure even more, since professionals can work in many surgical rooms and various surgi-www.ee.usp.br/reeusp Composition of the electrocautery smoke: integrative literature review cal procedures daily.…”

“…Harmful gases including carcinogens produced during transurethral resection of the prostate and vaporization (27) 2010 Jeonju, South Korea…”

“…Category Compounds found in the electrocautery smoke E1 (3) and E2 (20) First PAH E3 (5) Second Volatile compounds E4 (21) , E5 (4) , E6 (22) , E7 (23) , E8 (24) , E9 (25) , E10 (26) , E11 (27) , E12 (28) , E13 (29) and E14 (30) Third VOC…”

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

“…It is well established that the chemical composition of surgical smoke varies by the type of tissue dissected. For example, research has revealed that muscular tissue produces aldehyde and ketone; liver and fatty tissue liberates carbon monoxide and hydrocyanic acid (Barrett & Garber, 2003); epidermal tissue produces xylene, toluene, and ethyl benzene (Barrett & Garber, 2003;Moot et al, 2007;Wu et al, 2011); and prostate resection produces benzene, formaldehyde, carbon monoxide, butadiene, vinyl acetylene, and acrylonitrile (Chung et al, 2010;Weston, Stephenson, Kutarski, & Parr, 2009). Surgical smoke also contains a variety of cellular particles that could cause infections (Alp, Bijl, Bleichrodt, Hansson, & Voss, 2006).…”

“…All chemical levels were below maximum exposure limits, however, CO ware at levels to produce adverse effects to the surgeon. Chung, et al 2010.…”