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Surg Endosc ; 36(2): 1243-1250, 2022 02.
Article in English | MEDLINE | ID: covidwho-1092681


BACKGROUND: Surgical smoke during operation is a well-known health hazard for medical staff. This study aimed to investigate the dynamics of surgical smoke during open surgery or laparoscopic surgery for colorectal disease. METHODS: This study quantitated particulate matter (PM) counts as part of surgical smoke in 31 consecutive patients who underwent colectomy at the Niigata City General Hospital using a laser particle counter. Particles were graded by size as ≤ 2.5 µm PM (PM2.5) or > 2.5 µm PM (large PM). Operative procedures were categorized as either open surgery (n = 14) or laparoscopic surgery (n = 17). RESULTS: The median patient age was 72 (range 41-89) years and 58.1% were male. The total PM2.5, PM2.5 per hour, and maximum PM2.5 per minute counts during operation were significantly higher in open surgery than in laparoscopic surgery (P = 0.001, P < 0.001, and P = 0.029, respectively). Large PM counts (total, per hour, and maximum per minute) were also higher in the open surgery group than in the laparoscopic surgery group. The maximum PM2.5 concentration recorded was 38.6 µm/m3, which is considered "unhealthy for sensitive groups" according to the U.S. Environment Protection Agency air quality index standards, if it was a 24-h period mean value. CONCLUSION: Exposure to surgical smoke is lower during laparoscopic surgery than during open surgery for colorectal diseases.

COVID-19 , Colorectal Neoplasms , Laparoscopy , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , SARS-CoV-2 , Smoke/adverse effects
J Cardiovasc Thorac Res ; 12(2): 136-139, 2020.
Article in English | MEDLINE | ID: covidwho-626461


Introduction: The knowledge regarding the demographic characteristics of patients with Covid-19 and risk factors distribution is still evolving. Considering the role of cigarette smoking in the pathogenesis of lung diseases and the effect of nicotine on expression of the entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is important to determine the implications of smoking in COVID-19. Methods: In this brief report, by using the published articles in the literature, we aimed to compare the reported prevalence of smoking in patients with COVID-19 to the prevalence of smoking in the general population of the corresponding report. Binomial tests were conducted and a P value of less than 0.05 was considered statistically significant. Results: Among the screened papers, we found 12 peer-reviewed articles in which epidemiological characteristics of COVID-19 patients, including smoking status, were stated. Based on the descriptive reports of characteristics of COVID-19 patients, we observed a significantly lower proportion of COVID-19 patients with smoking history compared to what is expected, given the population average for each study's geographic area. Conclusion: This analysis of available data showed a lower prevalence of smoking in COVID-19 patients in comparison to the regional average. Considering the limitations of the study, the results should be interpreted with great caution and be viewed just as a preliminary report to motivate related basic and clinical researches.

Eur Urol Focus ; 6(5): 1058-1069, 2020 09 15.
Article in English | MEDLINE | ID: covidwho-548746


CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic raised concerns about the safety of laparoscopy due to the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diffusion in surgical smoke. Although no case of SARS-CoV-2 contagion related to surgical smoke has been reported, several international surgical societies recommended caution or even discouraged the use of a laparoscopic approach. OBJECTIVE: To evaluate the risk of virus spread due to surgical smoke during surgical procedures. EVIDENCE ACQUISITION: We searched PubMed and Scopus for eligible studies, including clinical and preclinical studies assessing the presence of any virus in the surgical smoke from any surgical procedure or experimental model. EVIDENCE SYNTHESIS: We identified 24 studies. No study was found investigating SARS-CoV-2 or any other coronavirus. About other viruses, hepatitis B virus was identified in the surgical smoke collected during different laparoscopic surgeries (colorectal resections, gastrectomies, and hepatic wedge resections). Other clinical studies suggested a consistent risk of transmission for human papillomavirus (HPV) in the surgical treatments of HPV-related disease (mainly genital warts, laryngeal papillomas, or cutaneous lesions). Preclinical studies showed conflicting results, but HPV was shown to have a high risk of transmission. CONCLUSIONS: Although all the available data come from different viruses, considering that the SARS-CoV-2 virus has been shown in blood and stools, the theoretical risk of virus diffusion through surgical smoke cannot be excluded. Specific clinical studies are needed to understand the effective presence of the virus in the surgical smoke of different surgical procedures and its concentration. Meanwhile, adoption of all the required protective strategies, including preoperative patient nasopharyngeal swab for COVID-19, seems mandatory. PATIENT SUMMARY: In this systematic review, we looked at the risk of virus spread from surgical smoke exposure during surgery. Although no study was found investigating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or any other coronavirus, we found that the theoretical risk of virus diffusion through surgical smoke cannot be excluded.

Betacoronavirus , Coronavirus Infections/transmission , Hepatitis B virus , Infectious Disease Transmission, Patient-to-Professional , Laparoscopy , Papillomaviridae , Pneumonia, Viral/transmission , Smoke , COVID-19 , Colectomy , Condylomata Acuminata/surgery , Condylomata Acuminata/virology , Gastrectomy , Hepatectomy , Humans , Laryngeal Neoplasms/surgery , Laryngeal Neoplasms/virology , Minimally Invasive Surgical Procedures , Pandemics , Papilloma/surgery , Papilloma/virology , Papillomavirus Infections , Risk , SARS-CoV-2 , Warts/surgery , Warts/virology