title: 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 0.05L/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±standard deviation) of chemical components in the 45L of gas and room air mixture produced during TURP and vaporization were as follows: propylene, 0.80±0.52mg; isobutylene, 212.85±75.65mg; 1,3-butadiene, 0.93±0.34mg; ethyl acetylene, 0.09±0.05mg; 1-pentene, 6.75±1.62mg; 1,4-pentadiene, 0.06±0.02mg; and acrylonitrile, 1.62±1.19mg.
  
  
  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.
authors.affiliation: Center for University-wide Research Facilities, Department of Anesthesiology and Urology, Medical School Institute for Medical Sciences, Chonbuk National University, Jeonju, Korea.
authors.forename: Yun Jo
authors.initials: YJ
authors.lastname: Chung
authors.forename: Sang Kyi
authors.initials: SK
authors.lastname: Lee
authors.forename: Suk Hee
authors.initials: SH
authors.lastname: Han
authors.forename: Chen
authors.initials: C
authors.lastname: Zhao
authors.forename: Myung Ki
authors.initials: MK
authors.lastname: Kim
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Park
authors.forename: Jong Kwan
authors.initials: JK
authors.lastname: Park
mesh_terms: D000368:Aged; D000475:Alkenes / Q000032:analysis; D002070:Butadienes / Q000032:analysis; D002273:Carcinogens / Q000032:analysis*; D015331:Cohort Studies; D004784:Environmental Monitoring; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D005740:Gases / Q000032:analysis*; D015386:Hazardous Substances / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D016273:Occupational Exposure / Q000032:analysis*; D016272:Occupational Health; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012906:Smoke / Q000032:analysis*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods; D014835:Volatilization
chemical_list: D000475:Alkenes; D002070:Butadienes; D002273:Carcinogens; D005740:Gases; D015386:Hazardous Substances; D012906:Smoke