Harmful gases including carcinogens produced during transurethral resection of the prostate and vaporization.
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.
Chung
Yun Jo
YJ
Center for University-wide Research Facilities, Department of Anesthesiology and Urology, Medical School Institute for Medical Sciences, Chonbuk National University, Jeonju, Korea.
Lee
Sang Kyi
SK
Han
Suk Hee
SH
Zhao
Chen
C
Kim
Myung Ki
MK
Park
Seung Chul
SC
Park
Jong Kwan
JK
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
D000475:Alkenes; D002070:Butadienes; D002273:Carcinogens; D005740:Gases; D015386:Hazardous Substances; D012906:Smoke