Surgical plume from tissue infected with human hepatitis B virus can contain viral substances.

Abstract

INTRODUCTION:

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.

MATERIAL AND METHODS:

Experiment 1, ex-vivo model: Tumor mass of a hepatocellular carcinoma line was prepared in a Nod/SCID 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. Experiment 2, clinical specimen: 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.

RESULTS:

Experiment 1: 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. Experiment 2: 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.

CONCLUSIONS:

DNA fragments or antigens of virus can exist in the surgical plume generated by EC or US.

• Authors: Masashi Hirota, Hidekazu Takahashi, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Makoto Yamasaki, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima
• Journal: Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy (Minim Invasive Ther Allied Technol) Vol. 31 Issue 5 Pg. 728-736 (Jun 2022) ISSN: 1365-2931 [Electronic] England
• PMID: 33853487 (Publication Type: Journal Article)

Chemical References

• Aerosols
• DNA, Viral
• Hepatitis B Surface Antigens
• alpha-Fetoproteins

Topics

• Aerosols (analysis)
• Animals
• Carcinoma, Hepatocellular (surgery)
• DNA, Viral (isolation & purification)
• Electrocoagulation
• Hepatitis B Surface Antigens (isolation & purification)
• Hepatitis B virus (isolation & purification)
• Humans
• Liver Neoplasms (surgery)
• Mice
• Mice, SCID
• Ultrasonic Surgical Procedures
• alpha-Fetoproteins