Andréasson S N, Anundi H, Sahlberg B, Ericsson C-G, Wålinder R, Enlund G, Påhlman L, Mahteme H
Department of Main Operating Theatres, Uppsala University Hospital, Sweden.
Eur J Surg Oncol. 2009 Jul;35(7):780-4. doi: 10.1016/j.ejso.2008.09.002. Epub 2008 Oct 15.
To adequately perform peritonectomy, the use of an electrocautery device at a high voltage is recommended. The aim of this study was to analyse the amount of airborne and ultrafine particles (UFP) generated during peritonectomy and to compare this with standard colon and rectal cancer surgery (CRC).
UFP was measured approximately 2-3 cm from the breathing area of the surgeon (personal sampling) and 3 m from where the electrocautery smoke was generated (stationary sampling) from 14 consecutive peritonectomy procedures and 11 standard CRC resections. The sampling was by P-Trak UFP counter that has the capacity to detect particle size ranging from 0.02 to 1 microm.
The cumulative level of UFP of personal sampling in the peritonectomy group was higher (9.3 x 10(6) particle/ml/h (pt/ml/h)) than in the control group (4.8 x 10(5) pt/ml/h). A higher cumulative level of UFP in stationary sampling was observed in the PC group (2.6 x 10(6) pt/ml/h) than in the control group (3.9 x 10(4)pt/ml/h).
Peritonectomy procedure with high voltage electrocautery generates elevated levels of UFP than standard CRC surgery does. The level of UFP produced by a peritonectomy is comparable to cigarette smoking. More efficient smoke evacuator systems are needed in order to reduce the levels of UFP generated during electrocautery surgery.
为了充分进行腹膜切除术，建议使用高电压的电灼设备。本研究的目的是分析腹膜切除术过程中产生的空气传播颗粒和超细颗粒（UFP）的数量，并将其与标准的结肠癌和直肠癌手术（CRC）进行比较。
在连续14例腹膜切除术和11例标准CRC切除术中，从外科医生呼吸区域约2-3厘米处（个人采样）以及电灼烟雾产生处3米处（固定采样）测量UFP。采样使用P-Trak UFP计数器，其能够检测粒径范围为0.02至1微米的颗粒。
腹膜切除术组个人采样的UFP累积水平高于对照组（9.3×10⁶颗粒/毫升/小时（pt/ml/h）对4.8×10⁵ pt/ml/h）。PC组固定采样中观察到的UFP累积水平高于对照组（2.6×10⁶ pt/ml/h对3.9×10⁴ pt/ml/h）。
与标准CRC手术相比，高电压电灼的腹膜切除术产生的UFP水平更高。腹膜切除术产生的UFP水平与吸烟相当。需要更有效的烟雾抽吸系统以降低电灼手术期间产生的UFP水平。
