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Effect of continuous negative pressure suction through chest wall in solving the smoke problem in video-assisted thoracic surgery |
LI Weiqing, LI Zhitian, GUO Huiqin |
Department of Thoracic Surgery, Beijing Shijitan Hospital affiliated to Capital Medical University, Beijing 100038, China |
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Abstract Objective To investigate the effect of continuous negative pressure suction through chest wall in solving the smoke problem in video-assisted thoracic surgery.Methods One hundred and three patients who underwent single-port thoracoscopic lobectomy from March 2021 to June 2021 were divided into two groups according to patients’will (48 in group A and 55 in group B). The patients applied with the smoke extraction method during operation were classified into group A, while those who were not used with the method were classified into group B. The age, gender, body mass index (BMI), resection range, tumor diameter, TNM stage, operation time, blood loss, intraoperative lens wiping times, postoperative length of hospital stay and intraoperative PM 2.5 in operating room of the two groups were compared.Results The operative time in group A was (105.14±35.27) min, which was shorter than that in group B [(130.15±38.36) min, P<0.001]. The number of lens wiping in group A was 2.43±2.55, which was significantly lower than 7.33±4.12 in group B (P<0.001). The blood loss in group A was (85.58±33.45) ml, while the amount in group B was (106.43±34.23)ml. And there were no statistically significant differences in age, gender, BMI, tumor location, TNM stage and postoperative length of hospital stay between the two groups. In terms of the improvement of air quality in the operating room, the concentration of PM2.5 in group A was (55.43±25.12) μg/m3, much lower than that in group B [(654.34±108.76) μg/m3, P<0.001]. After 10 min of chest closure, the operating room PM 2.5 of the two groups still showed significant difference (P<0.001).Conclusions The continuous negative pressure suction through chest is simple and effective, which can effectively shorten the operation time and reduce the fuzzy lens, the amount of intraoperative blood loss and the pollution of operating rooms.
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Received: 09 February 2022
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[1] |
Mattes D, Silajdzic E, Mayer M, et al. Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study [J]. Surg Endosc, 2010, 24(10): 2492-2501.
|
[2] |
Manning T G, Papa N, Perera M, et al. Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model [J]. Surg Endosc, 2018, 32(3):1600-1606.
|
[3] |
Ilce A, Yuzden G E, van Giersbergen M Y. The examination of problems experienced by nurses and doctors associated with exposure to surgical smoke and the necessary precautions [J]. J Clin Nurs,2017, 26(11-12):1555-1561.
|
[4] |
Limchantra I V, Fong Y, Melstrom K A. Surgical smoke exposure in operating room personnel: a review [J]. JAMA Surg, 2019, 154(10): 960-967.
|
[5] |
Irino T, Hiki N, Ohashi M, et al. The hit and away technique: optimal usage of the ultrasonic scalpel in laparoscopic gastrectomy [J]. Surg Endosc, 2016, 30(1): 245-250.
|
[6] |
Song T, Lee D H. A randomized Comparison of laparoscopic LEns defogging using Anti-fog solution, warm saline, and chlorhexidine solution (CLEAR) [J]. Surg Endosc, 2020, 34(2):940-945.
|
[7] |
Hill D S, O’Neill J K, Powell R J, et al. Surgical smoke-a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units [J]. J Plast Reconstr Aesthet Surg, 2012, 65(7): 911-916.
|
[8] |
Brace M D, Stevens E, Taylor S M, et al. "The air that we breathe": assessment of laser and electrosurgical dissection devices on operating theater air quality [J]. J Otolaryngol-Head N, 2014, 43(1): 39.
|
[9] |
Choi S H, Kwon T G, Chung S K, et al. Surgical smoke may be a biohazard to surgeons performing laparoscopic surgery [J]. Surg Endosc, 2014, 28(8): 2374-2380.
|
[10] |
Fencl J L. Guideline implementation: surgical smoke safety [J]. AORN J, 2017, 105(5):488-497.
|
[11] |
Okoshi K, Kobayashi K, Kinoshita K, et al. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel [J]. Surg Today, 2015, 45(8): 957-965.
|
[12] |
Alp E, Bijl D, Bleichrodt R P, et al. Surgical smoke and infection control [J]. J Hosp Infect, 2006, 62(1): 1-5.
|
[13] |
Mintz Y, Arezzo A, Boni L, et al. A low-cost, safe, and effective method for smoke evacuation in laparoscopic surgery for suspected coronavirus patients [J]. Ann Surg, 2020, 272(1): e7-e8.
|
[14] |
Manning T G, Perera M, Christidis D, et al. Visual occlusion during minimally invasive surgery: a contemporary review of methods to reduce laparoscopic and robotic lens fogging and other sources of optical loss [J]. J Endourol, 2017, 31(4): 327-333.
|
[15] |
杨 洋,马燕兰,曹冠楠,等.除烟装置清除腹腔镜胆囊切除术烟雾中有机物的作用[J]. 武警医学,2018,29(12):1117-1120.
|
[16] |
Zheng M H, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy [J]. Ann Surg, 2020, 272(1): e5-e6.
|
[17] |
Rakovich G, Urbanowicz R, Issa R, et al. Minimizing the risk of aerosol contamination during elective lung resection surgery [J]. Ann Surg, 2020, 272(2): e125-e128.
|
[18] |
Zhang J, Zhu B. Comment on: a low-cost, safe, and effective method for smoke evacuation in laparoscopic surgery for suspected coronavirus patients [J]. Ann Surg, 2021, 274(6):e895.
|
[19] |
Zhang X, Yang L, Wang J, et al. Innovative solution for grasping forceps support suction to facilitate uniportal video-assisted thoracoscopic surgery [J]. Thorac Cardiovasc Surg, 2019, 67(2):151-154.
|
[20] |
林 雅,吴晓丹,陈 臻.一次性输血器排烟雾法在微创食管癌手术护理中的应用[J]. 福建医药杂志,2016,38(6):164-166.
|
[1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(7): 623-624. |
|
|
|
|