L Munster, B van der Zwet, J de Groof, M Mundt, O van Ruler, G D'Haens, W Bemelman, C Buskens, M Duijvestein, T Stobernack, J van der Bilt
{"title":"炎症性肠病常见手术的碳足迹。","authors":"L Munster, B van der Zwet, J de Groof, M Mundt, O van Ruler, G D'Haens, W Bemelman, C Buskens, M Duijvestein, T Stobernack, J van der Bilt","doi":"10.1007/s10151-025-03123-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the environmental impact, primarily the carbon footprint of the most common procedures in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>In this study, all processes and products used during a total of eight laparoscopic ileocecal resections (ICRs) in patients with Crohn's disease (CD), eight laparoscopic subtotal colectomies (STCs) for ulcerative colitis (UC), and eight ligation of the intersphincteric fistula tract (LIFT) procedures in patients with Crohn's perianal fistula (PAF) (all in adults ≥ 16 years) between March 2023 and May 2024 were collected. A life cycle assessment (LCA) was conducted, mean CO<sup>2</sup> emission rates were calculated, the major contributors (\"hotspots\") were determined, and midpoint/endpoint analysis was performed.</p><p><strong>Results: </strong>The mean total carbon footprints of laparoscopic ICR, STC, and LIFT were, respectively, 104 kg, 116 kg, and 43.6 kg CO<sup>2</sup>eq, equaling one-way trips by airplane from Amsterdam to Paris, to Manchester, and to Düsseldorf, respectively. The main contributors in laparoscopic ICR and STC were transport of employees and patients (48% and 49%, respectively), energy use in the theater (21% and 27%, respectively), and the use of surgical equipment (14% and 17%, respectively). In LIFT procedures, transport of employees/patients accounted for 47% of total emission rates, followed by the use of surgical equipment (28%), and electricity use in the theater (13%). Besides the impact on global warming, significant impact on fine particulate matter formation, land use, terrestrial acidification, and fossil resource scarcity was identified. Endpoint analysis showed an amount of disability-adjusted life years (DALYs) of approximately 2 h of health damage per laparoscopic ICR/STC and 47 min per LIFT.</p><p><strong>Conclusions: </strong>The carbon footprint of three commonly performed IBD surgeries is mainly determined by transportation of patients/healthcare personnel, followed by electricity and material use. The latter two vary with the complexity of the surgeries. IBD surgeons should focus on minimizing energy resources and using standard surgical materials. Also, employees should be encouraged to travel by foot/bicycle/public transport/carpooling/electric car.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"127"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125120/pdf/","citationCount":"0","resultStr":"{\"title\":\"Carbon footprint of common procedures in inflammatory bowel disease.\",\"authors\":\"L Munster, B van der Zwet, J de Groof, M Mundt, O van Ruler, G D'Haens, W Bemelman, C Buskens, M Duijvestein, T Stobernack, J van der Bilt\",\"doi\":\"10.1007/s10151-025-03123-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of this study was to assess the environmental impact, primarily the carbon footprint of the most common procedures in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>In this study, all processes and products used during a total of eight laparoscopic ileocecal resections (ICRs) in patients with Crohn's disease (CD), eight laparoscopic subtotal colectomies (STCs) for ulcerative colitis (UC), and eight ligation of the intersphincteric fistula tract (LIFT) procedures in patients with Crohn's perianal fistula (PAF) (all in adults ≥ 16 years) between March 2023 and May 2024 were collected. A life cycle assessment (LCA) was conducted, mean CO<sup>2</sup> emission rates were calculated, the major contributors (\\\"hotspots\\\") were determined, and midpoint/endpoint analysis was performed.</p><p><strong>Results: </strong>The mean total carbon footprints of laparoscopic ICR, STC, and LIFT were, respectively, 104 kg, 116 kg, and 43.6 kg CO<sup>2</sup>eq, equaling one-way trips by airplane from Amsterdam to Paris, to Manchester, and to Düsseldorf, respectively. The main contributors in laparoscopic ICR and STC were transport of employees and patients (48% and 49%, respectively), energy use in the theater (21% and 27%, respectively), and the use of surgical equipment (14% and 17%, respectively). In LIFT procedures, transport of employees/patients accounted for 47% of total emission rates, followed by the use of surgical equipment (28%), and electricity use in the theater (13%). Besides the impact on global warming, significant impact on fine particulate matter formation, land use, terrestrial acidification, and fossil resource scarcity was identified. Endpoint analysis showed an amount of disability-adjusted life years (DALYs) of approximately 2 h of health damage per laparoscopic ICR/STC and 47 min per LIFT.</p><p><strong>Conclusions: </strong>The carbon footprint of three commonly performed IBD surgeries is mainly determined by transportation of patients/healthcare personnel, followed by electricity and material use. The latter two vary with the complexity of the surgeries. IBD surgeons should focus on minimizing energy resources and using standard surgical materials. Also, employees should be encouraged to travel by foot/bicycle/public transport/carpooling/electric car.</p>\",\"PeriodicalId\":51192,\"journal\":{\"name\":\"Techniques in Coloproctology\",\"volume\":\"29 1\",\"pages\":\"127\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125120/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Coloproctology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10151-025-03123-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-025-03123-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究的目的是评估炎症性肠病（IBD）中最常见手术的环境影响，主要是碳足迹。方法：本研究收集了2023年3月至2024年5月期间克罗恩病（CD）患者的8例腹腔镜回盲切除术（ICRs）、溃疡性结肠炎（UC）患者的8例腹腔镜结肠次全切除术（STCs）和克罗恩肛周瘘（PAF）患者的8例括括肌间瘘道结扎（LIFT）手术（所有成人≥16岁）中使用的所有过程和产品。进行生命周期评估（LCA），计算平均CO2排放率，确定主要贡献者（“热点”），并进行中点/终点分析。结果：腹腔镜ICR、STC和LIFT的平均总碳足迹分别为104 kg、116 kg和43.6 kg CO2eq，分别相当于从阿姆斯特丹到巴黎、到曼彻斯特和到塞尔多夫的单程航班。腹腔镜ICR和STC的主要贡献因素是员工和患者的运输（分别为48%和49%）、手术室的能源使用（分别为21%和27%）和手术设备的使用（分别为14%和17%）。在LIFT手术中，员工/患者的运输占总排放量的47%，其次是手术设备的使用（28%）和手术室的电力使用（13%）。除了对全球变暖的影响外，还对细颗粒物的形成、土地利用、陆地酸化和化石资源稀缺产生了显著影响。终点分析显示，每次腹腔镜ICR/STC的残疾调整生命年（DALYs）约为2小时的健康损害，每次LIFT约为47分钟。结论：三种常见IBD手术的碳足迹主要由患者/医护人员的运输决定，其次是电力和材料的使用。后两者随手术的复杂程度而变化。IBD外科医生应关注最小化能量资源和使用标准手术材料。此外，应该鼓励员工步行/骑自行车/乘坐公共交通工具/拼车/电动汽车。
Carbon footprint of common procedures in inflammatory bowel disease.
Background: The aim of this study was to assess the environmental impact, primarily the carbon footprint of the most common procedures in inflammatory bowel disease (IBD).
Methods: In this study, all processes and products used during a total of eight laparoscopic ileocecal resections (ICRs) in patients with Crohn's disease (CD), eight laparoscopic subtotal colectomies (STCs) for ulcerative colitis (UC), and eight ligation of the intersphincteric fistula tract (LIFT) procedures in patients with Crohn's perianal fistula (PAF) (all in adults ≥ 16 years) between March 2023 and May 2024 were collected. A life cycle assessment (LCA) was conducted, mean CO2 emission rates were calculated, the major contributors ("hotspots") were determined, and midpoint/endpoint analysis was performed.
Results: The mean total carbon footprints of laparoscopic ICR, STC, and LIFT were, respectively, 104 kg, 116 kg, and 43.6 kg CO2eq, equaling one-way trips by airplane from Amsterdam to Paris, to Manchester, and to Düsseldorf, respectively. The main contributors in laparoscopic ICR and STC were transport of employees and patients (48% and 49%, respectively), energy use in the theater (21% and 27%, respectively), and the use of surgical equipment (14% and 17%, respectively). In LIFT procedures, transport of employees/patients accounted for 47% of total emission rates, followed by the use of surgical equipment (28%), and electricity use in the theater (13%). Besides the impact on global warming, significant impact on fine particulate matter formation, land use, terrestrial acidification, and fossil resource scarcity was identified. Endpoint analysis showed an amount of disability-adjusted life years (DALYs) of approximately 2 h of health damage per laparoscopic ICR/STC and 47 min per LIFT.
Conclusions: The carbon footprint of three commonly performed IBD surgeries is mainly determined by transportation of patients/healthcare personnel, followed by electricity and material use. The latter two vary with the complexity of the surgeries. IBD surgeons should focus on minimizing energy resources and using standard surgical materials. Also, employees should be encouraged to travel by foot/bicycle/public transport/carpooling/electric car.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
