Hirota Masashi, Takahashi Hidekazu, Miyazaki Yasuhiro, Takahashi Tsuyoshi, Kurokawa Yukinori, Yamasaki Makoto, Eguchi Hidetoshi, Doki Yuichiro, Nakajima Kiyokazu
Department of Next Generation Endoscopic Intervention, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Minim Invasive Ther Allied Technol. 2022 Jun;31(5):728-736. doi: 10.1080/13645706.2021.1910848. Epub 2021 Apr 14.
Evidence on the biological danger associated with surgical plume is lacking. We examined whether surgical plume, generated by the energy devices ultrasonically activated scalpel (US) or electrocautery (EC) contains virus-related substances.
Tumor mass of a hepatocellular carcinoma line was prepared in a mouse. Surgical plume generated on the mass by US or EC was collected and detection of HBs gene fragment and antigens (HBsAg or AFP) was conducted. : Detection of HBV-DNA and HBsAg was conducted following the collection of surgical plume generated from clinically obtained liver specimens from six HBV-associated hepatocellular carcinoma patients.
HBs gene fragment was detected in the solutions regardless of the device used. HBsAg was detected in US and EC solutions and AFP was also detected in a US solution. HBV-DNA was detected in both devices, in all three cases whose preoperative serum HBV-DNA was positive. In the other serum-negative cases, HBV-DNA was not detected. While serum HBsAg was positive in five of six cases, it was not detected in any solution.
DNA fragments or antigens of virus can exist in the surgical plume generated by EC or US.
缺乏关于手术烟雾相关生物危害的证据。我们研究了由超声刀（US）或电灼（EC）等能量设备产生的手术烟雾中是否含有病毒相关物质。
在小鼠体内制备肝癌细胞系的肿瘤块。收集由US或EC在肿瘤块上产生的手术烟雾，并检测乙肝表面抗原基因片段和抗原（乙肝表面抗原或甲胎蛋白）。从6例乙肝相关肝癌患者的临床肝脏标本中收集手术烟雾后，进行乙肝病毒DNA和乙肝表面抗原的检测。
无论使用何种设备，在溶液中均检测到乙肝表面抗原基因片段。在超声刀和电灼溶液中检测到乙肝表面抗原，在超声刀溶液中还检测到甲胎蛋白。在术前血清乙肝病毒DNA呈阳性的所有3例病例中，两种设备产生的烟雾中均检测到乙肝病毒DNA。在其他血清阴性病例中，未检测到乙肝病毒DNA。虽然6例中有5例血清乙肝表面抗原呈阳性，但在任何溶液中均未检测到。
电灼或超声刀产生的手术烟雾中可能存在病毒的DNA片段或抗原。
