Tokuda Yutaka, Okamura Takuho, Maruta Miki, Orita Mutsuko, Noguchi Miyuki, Suzuki Toshiyasu, Matsuki Hideaki
Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan.
Breast Center, Seirei Yokohama Hospital, Yokohama, Japan.
J Occup Med Toxicol. 2020 May 25;15:13. doi: 10.1186/s12995-020-00259-y. eCollection 2020.
No prospective evaluation of surgical smoke evacuation systems has yet been conducted anywhere in the world. A prospective randomized study was conducted to clarify the usefulness of a surgical smoke evacuation system in terms of reducing the quantity of environmental pollutants found in operating room air and reducing the occupational exposure of doctors and nurses involved in surgical procedures to surgical smoke, volatile organic compounds, formaldehyde, etc.
Operating room environment conditions with and without the use of a surgical smoke evacuation system were measured, and the personal exposure levels of doctors and nurses involved in surgical procedures were also surveyed. Use of the evacuation system was determined randomly, and the procedures involved were breast-conserving surgery and mastectomy, which were treated as stratification factors.
The average total volatile organic compound concentration in the operating room was significantly lower when the evacuation system was used compared with when it was not used. The findings were similar for formaldehyde concentration. Multiple regression analysis for healthcare professionals' personal exposure levels showed that the evacuation system was a factor that significantly impacted their formaldehyde and acetaldehyde personal exposure levels, which were greatly reduced by the use of the system.
This study's findings demonstrate the effectiveness of the evacuation systems, which should increase awareness that their benefits take priority over the drawbacks.
The study was conducted after explaining to participants that it was a study of operating room environments in which their participation was voluntary and obtaining their consent. The study was also approved by the Tokai University Hospital clinical research review committee (no. 5R-022) and registered with the UMIN registry (UMIN000029092) on 13, September, 2017- retrospectively registered.
全球范围内尚未对手术烟雾抽吸系统进行前瞻性评估。本前瞻性随机研究旨在明确手术烟雾抽吸系统在减少手术室空气中环境污染物数量以及降低参与手术的医生和护士职业暴露于手术烟雾、挥发性有机化合物、甲醛等方面的效用。
测量了使用和未使用手术烟雾抽吸系统时的手术室环境条件，并调查了参与手术的医生和护士的个人暴露水平。随机确定是否使用抽吸系统，所涉及的手术为保乳手术和乳房切除术，并将其作为分层因素。
与未使用抽吸系统时相比，使用该系统时手术室中挥发性有机化合物的平均总浓度显著降低。甲醛浓度的结果类似。对医护人员个人暴露水平的多元回归分析表明，抽吸系统是显著影响其甲醛和乙醛个人暴露水平的一个因素，使用该系统后这些暴露水平大幅降低。
本研究结果证明了抽吸系统的有效性，这应提高人们对其益处优先于弊端的认识。
在向参与者解释这是一项关于手术室环境的研究（其参与是自愿的）并获得他们的同意后开展了本研究。该研究还获得了东海大学医院临床研究审查委员会（编号5R - 022）的批准，并于2017年9月13日在UMIN注册中心注册（UMIN000029092）——回顾性注册。
