Transurethral electrosurgery smoke ‘poses hazard’
medwireNews: Researchers from South Korea say that more attention must be given to the risks of smoke exposure during transurethral electrosurgery, after finding that a variety of gases are produced, including some that are carcinogenic.
The team, led by Jong Kwan Park (Chonbuk National University, Jeonju), assessed the gases produced during transurethral resection of the prostate (TURP) and transurethral resection of the bladder (TURB) for 18 cases of benign hypertrophic prostate and 18 cases of malignant bladder tumor.
They found that a greater variety of gases were produced during TURB than during TURP, identifying 39 and 16 different compounds from the two procedures, respectively.
These included a number of human carcinogens, such as 1,3-butadiene, vinyl acetylene, and ethyl acetylene during TURP, and acetaldehyde, benzene, toluene, and ethlybenzene during TURB. The authors also note that several known animal carcinogens were produced during both types of procedure, as well as gases with carcinogenic potential that have yet to be officially classified.
The team says that their findings suggest that electrosurgery of malignant tissues may potentially produce more hazardous gases than that for benign conditions, which is something that warrants further study.
The researchers explain that as surgical masks only protect against particles larger than 5 µm, strategies must be implemented to protect surgical staff and patients.
“To prevent the inhalation of surgical smoke, a continuous irrigation and suction system during transurethral surgery is needed because surgical masks do not completely prevent smoke intake,” they write in Urology.
“Furthermore a surgical smoke evacuation system or smoke filters, or both, should be developed and then made readily available to both operating room [personnel] and patients to ensure their safety during transurethral surgery.”
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By Kirsty Oswald, medwireNews Reporter