Zhaoxia Luo,Xiuze Li,Shuhua Li,Bo Hou. A study of the potential adverse effects of electrosurgical smoke on medical staff during malignant tumor surgery. Oncol Transl Med, 2021, 7: 136-140.
A study of the potential adverse effects of electrosurgical smoke on medical staff during malignant tumor surgery
Received:July 22, 2020  Revised:June 26, 2021
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KeyWord:electrosurgery; ultrasonic scalpel; malignant tumor; smoke
Author NameAffiliationE-mail
Zhaoxia Luo Operation Room, Mianyang Central Hospital whx20212020@163.com 
Xiuze Li Operation Room, Mianyang Central Hospital  
Shuhua Li Operation Room, Mianyang Central Hospital  
Bo Hou Operation Room, Mianyang Central Hospital hhh1471232021@163.com 
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Abstract:
      Objective The aim of this study was to investigate the potential adverse effects of electrosurgical smoke on medical staff performing malignant tumor surgery. Methods This study was divided into two parts: in vitro and in vivo experiments. The human thyroid cancer cell line, ARO, was cultured and passaged. The tumor cells were burned with an ultrasonic scalpel, and the surgical smoke was absorbed by a transwell membrane. The captured particles were diluted in 3 mL of culture medium, and cell survival was assessed under a microscope. DNA was extracted from the cells for genotyping. BALB/c mice were used to construct thyroid cancer xenograft models. The tumor tissues were dissected on day 14 using an ultrasonic scalpel. The smoke from the electrosurgical procedure was collected on a transwell membrane. The membrane was washed in 2 mL of rinsing solution, and the solution was then injected into the right armpit of 10 mice. After sacrifice, the tumor tissues were removed and stained with hematoxylin and eosin (HE). Results Viable ARO cells could be seen on the first day after culturing cell fragments from surgical smoke, and vigorous cell proliferation could be seen on the 17th day of incubation. The genotype of the cells cultured in the presence of smoke particles was identical to the genotype of the original cells. Tumor growth was observed in four out of 10 mice injected with the smoke particle rinse. HE staining showed a significantly increased number of nuclei in the tumor tissue, which was consistent with the general morphological characteristics of malignant tumors. Conclusion Viable tumor cells were detected in surgical smoke generated by ultrasonic scalpel dissection, and these cells had growth activity. Thus, it is necessary to protect patients and medical staff from electrosurgical smoke.
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