Background: Surgical smoke is generated in over ۷۰% of surgical procedures and contains carcinogens, toxic gases, and bioaerosols. This poses health risks for both surgical teams and patients, including respiratory issues, eye irritation, and a heightened risk of cancer. Effective management of surgical smoke is essential for maintaining a safe operating environment. This meta-analysis evaluates the effectiveness of advanced technologies and safety protocols in addressing surgical smoke in operating rooms. It identifies best practices and aims to inform future guidelines to enhance occupational health and patient safety. Materials and Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library up to March ۲۰۲۴, using the terms: "surgical smoke," "operating room," "smoke management," "advanced technologies," and "safety protocols." The studies included in this search evaluated various technologies or protocols aimed at reducing or controlling surgical smoke in operating room settings. Exclusion criteria comprised studies conducted outside of operating room environments, reviews without primary data, and publications not written in English. The Cochrane Risk of Bias Tool was used to assess randomized trials, while observational studies were evaluated using the Newcastle-Ottawa Scale. Data synthesis was performed through both qualitative and quantitative methods, utilizing meta-analysis with random-effects models to address study heterogeneity. Results: A total of thirty studies involving ۴,۲۰۰ participants met the inclusion criteria. These studies included randomized controlled trials, cohort studies, and cross-sectional analyses. The technologies evaluated were high-efficiency smoke evacuation systems, ultraviolet (UV) air filtration units, and portable laser plume extractors. Safety protocols involved standardized guidelines, training programs, and the use of personal protective equipment (PPE). A meta-analysis revealed that advanced smoke evacuation systems reduced particulate matter by an average of ۵۰ µg/m³ (۹۵% confidence interval: -۶۵ to -۳۵, p < ۰.۰۰۱) compared to conventional methods. Additionally, the implementation of standardized safety protocols led to a ۴۰% reduction in respiratory symptoms among operating room personnel, with a relative risk of ۰.۶۰ (۹۵% CI: ۰.۴۵ to ۰.۸۰, p = ۰.۰۰۲). Furthermore, subgroup analyses showed that combining advanced technologies with rigorous safety protocols resulted in the most significant reductions in surgical smoke exposure, ultimately improving occupational health and safety. Conclusion: The integration of advanced smoke management technologies with comprehensive safety protocols markedly mitigates the detrimental effects of surgical smoke in operating rooms. These measures improve the health and safety of surgical teams while enhancing surgical outcomes. Future guidelines must integrate evidence-based practices to uphold elevated safety standards.
