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2020 ; 6
(5
): 1058-1069
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive
Surgery: A Systematic Review of the Literature on a Neglected Issue Revived in
the COVID-19 Pandemic Era
#MMPMID32527624
Pavan N
; Crestani A
; Abrate A
; De Nunzio C
; Esperto F
; Giannarini G
; Galfano A
; Gregori A
; Liguori G
; Bartoletti R
; Porpiglia F
; Simonato A
; Trombetta C
; Tubaro A
; Ficarra V
; Novara G
Eur Urol Focus
2020[Sep]; 6
(5
): 1058-1069
PMID32527624
show ga
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.