1
|
Zhang S, Wang Q, Feng Y, Zhang G, Chen Y, Zheng W, Wu X, Yang A. Clip or Tattooing: A Comparative Study for Preoperative Colon Cancer Endoscopic Localization. Front Oncol 2022; 12:846900. [PMID: 35280761 PMCID: PMC8916562 DOI: 10.3389/fonc.2022.846900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Aim Preoperative endoscopic markers have been extensively used for the localization of colonic neoplastic lesions in laparoscopic surgery. We conducted this respective cohort study to compare the localization accuracy of two commonly used endoscopic marker strategies (endoscopic clip plus abdominal plain film and endoscopic tattooing). Methods Patients who received preoperative colonoscopy localization for colonic neoplasia and underwent an elective laparoscopic operation afterward between 2013 and 2020 were included in this retrospective study. The localization accuracy of the two endoscopic strategies was compared, and the predictors of successful endoscopic localization were identified by multivariate regression. Results In total, 195 patients [average age 62.4 ± 9.2 years, 123 male (63.1%)] undergoing preoperative colonoscopy localization and subsequent laparoscopic colectomy for colonic neoplasms were included. Endoscopic localization was finally proven to be successful in 150 (76.9%) patients in the surgery. Compared to the tattooing group, patients who had successful localization for colonic lesions were fewer in the clip group (64 of 101 cases, 63.4% vs. 86 of 94 cases, 91.5%, p < 0.001). The multivariate regression analysis showed that the endoscopic tattooing strategy, endoscopic clip strategy, and lesion location were all predictors for successful localization (all with p < 0.001). Conclusion Compared with endoscopic clip plus abdominal plain film, endoscopic tattooing had higher localization accuracy and less intraoperative colonoscopy counseling; the endoscopic clip strategy, tattooing strategy, and colonic lesion location were all predictors of successful endoscopic localization.
Collapse
Affiliation(s)
- Shengyu Zhang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Qiang Wang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yunlu Feng
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Guannan Zhang
- Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yang Chen
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Weiyang Zheng
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Xi Wu
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Aiming Yang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| |
Collapse
|
2
|
The Usefulness of Preoperative Colonoscopic Tattooing with Autologous Blood for Localization in Laparoscopic Colorectal Surgery. THE JOURNAL OF MINIMALLY INVASIVE SURGERY 2020; 23:114-119. [PMID: 35602381 PMCID: PMC8985630 DOI: 10.7602/jmis.2020.23.3.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/18/2020] [Accepted: 08/11/2020] [Indexed: 11/08/2022]
Abstract
Purpose In colorectal cancer surgery, it is important to have accurate resection margins. However, it is challenging to localize lesions during laparoscopy. Therefore, to reduce surgical errors, many preoperative localizing methods have been introduced. In this study, we aimed to assess the preoperative feasibility and safety of autologous blood tattooing. Methods A total of 11 patients underwent preoperative colonoscopic autologous blood tattooing from August 2017 to February 2020. At the start of the surgery, the surgeon assessed the patients for the precision of visibility and other complications such as abscess or spillage. The patients’ characteristics, outcomes, and complications were collected retrospectively. Results The study comprised 8 men and 3 women, with an average age of 63 years. Ten patients showed precise visibility, and no localization errors were observed during surgery. No complication was observed in all patients. Conclusion Preoperative autologous blood tattooing is a very useful and safe technique because it has high visibility with no complications. This method does not require additional agents or facilities. A large-scale study will be required to develop standard guidelines.
Collapse
|
3
|
Bințințan V, Calborean A, Mocan M, Macavei S, Cordoș A, Ciuce C, Bințințan A, Chira R, Nagy G, Surlin V, Timofte D, Nickel F, Mueller B, Dindelegan G, Ciuce C, Brad S, Murar M, Mocan B. New inductive proximity sensor platform for precise localization of small colorectal tumors. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 106:110146. [PMID: 31753407 DOI: 10.1016/j.msec.2019.110146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 11/15/2022]
Abstract
Location of small gastric or colorectal tumors during a laparoscopic procedure is often imprecise and can be misleading. There is a real need for a compatible and straightforward tool that can be used intraoperatively to help the surgeon in this regard. We emphasize in the present work on the fabrication of a new and innovative inductive proximity switch architecture, fully compatible with laparoscopic surgery and with direct application in precise localisation of bowel tumors. An electromagnetic detection probe optimized for laparoscopic surgery and preconditioned for sterilisation was designed and constructed. Various metallic markers designed to be attached to the gastrointestinal mucosa were used for detection by the probe, from standard endoscopic and laparoscopic haemostatic clips to other custom made tags. Experiments were performed in dry and wet-lab experimental laboratory environment using ex-vivo segments of calf's small bowel and colonic surgical specimens from human patients. The dry-lab detection range varied considerably depending on the metallic component of the tags, from 0.5 mm for the endoscopic hemostatic clip to 3.5 mm for the 0.9 mm thickness stainless-steel custom tags. The latter was actually detectable from the serosal side of the fresh colonic surgical specimens in 85% of the attempts if the scanned area was less than 150 cm2 and less than 2 mm of fat was interposed between the probe and the bowel. The newly designed system has the potential to discover metallic tags attached to the bowel mucosa for precise intraoperative laparoscopic location of digestive tumors. Further work is in progress to increase the sensitivity and detection range of the system in order to make it fully compatible with the clinical use.
Collapse
Affiliation(s)
- Vasile Bințințan
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Adrian Calborean
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103, 400293 Cluj-Napoca, Romania.
| | - Mihaela Mocan
- Technical University Cluj Napoca, Memorandumului Street No. 28, 400114 Cluj Napoca, Romania
| | - Sergiu Macavei
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103, 400293 Cluj-Napoca, Romania
| | - Adrian Cordoș
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Catalin Ciuce
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Adriana Bințințan
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Romeo Chira
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Georgiana Nagy
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Valeriu Surlin
- University of Medicine and Pharmacy Craiova, Petru Rares Street No 2, 200349 Craiova, Romania; University of Medicine and Pharmacy Iasi, Universitatii Street Nr.16, 700115, Iasi, Romania
| | - Dan Timofte
- University of Medicine and Pharmacy Iasi, Universitatii Street Nr.16, 700115, Iasi, Romania
| | - Felix Nickel
- University of Heidelberg, Clinic of Surgery, INF 110, 69120 Heidelberg, Germany
| | - Beat Mueller
- University of Heidelberg, Clinic of Surgery, INF 110, 69120 Heidelberg, Germany
| | - George Dindelegan
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Constantin Ciuce
- Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, V. Babeş Street No. 8, 400012 Cluj-Napoca, Romania
| | - Stelian Brad
- Technical University Cluj Napoca, Memorandumului Street No. 28, 400114 Cluj Napoca, Romania
| | - Mircea Murar
- Technical University Cluj Napoca, Memorandumului Street No. 28, 400114 Cluj Napoca, Romania
| | - Bogdan Mocan
- Technical University Cluj Napoca, Memorandumului Street No. 28, 400114 Cluj Napoca, Romania
| |
Collapse
|
4
|
Costi R, Ricco' M, Negrini G, Wind P, Violi V, Le Bian AZ. "Is CT Scan more Accurate than Endoscopy in Identifying Distance from the Anal Verge for Left Sided Colon Cancer? A Comparative Cohort Analysis". J INVEST SURG 2018; 33:273-280. [PMID: 30089423 DOI: 10.1080/08941939.2018.1492650] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purposes: Accurately localizing colorectal cancer during surgery may be challenging due to intraoperative limitations. In the present study, localization of left-sided colon cancer (LCC) by CT scan is compared to colonoscopy. Material and methods: Consecutive patients with LCC located by colonoscopy and CT scan and undergoing left-hemicolectomy were included. Tumor distance from the anal verge (TDAV) was calculated by both CT-scan and colonoscopy, and then compared, using as reference TDAV measured intraoperatively. Statistical analysis was performed including (1) comparison of means between all three TDAVs, (2) comparison of mean differences between all three TDAVs, (3) comparison of number of patients with a difference between endoscopic TDAV and intraoperative TDAV ≤5 cm and the number of patients with a difference between CT scan TDAV and intraoperative TDAV ≤5 cm (4) statistical relationship between either CT scan and endoscopic and intraoperative TDAVs. Results: Both CT scan and endoscopy overestimate TDAV (25.8 ± 12.5 cm and 24.6 ± 10.6 cm vs. 21.5 ± 7.4 cm, p = 0.005), but CT scan TDAV resulted as being different from intraoperative TDAV (p < 0.01). Regression analysis reported an increasing divergence of measurements with increasing values of intraoperative TDAV, which resulted greater for CT. Tumors within 5 cm of intraoperative TDAV were 22/28 (78.6%) for endoscopy, and 17/28 (60.7%) for CT (p = 0.2448). Conclusions: Accuracy of both examinations seems poor, with a mean overestimation >3 cm and a significant number of tumors found at >5 cm from preoperative evaluation. Preoperative examinations' bias increase proportionally with TDAV length, decreasing their interest especially for tumors located at a greater distance from anal verge.
Collapse
Affiliation(s)
| | - Matteo Ricco'
- Dipartimento di Prevenzione, Unità Operativa di Prevenzione e Sicurezza sui Luoghi di Lavoro, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Giulio Negrini
- Servizio di Radiologia, Azienda Ospedaliero-Universita di Parma, Parma, Italia
| | - Philippe Wind
- Department of Digestive Surgery and Surgical Oncology, Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Paris XIII, Bobigny, France
| | - Vincenzo Violi
- Dipartimento di Scienze Chirurgiche, Università di Parma, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Italia, Parma.,Dipartimento di Chirurgia Generale e Specialistica, Unità Operativa di Chirurgia Generale, Ospedale di Fidenza, AUSL Parma, Fidenza, Italia
| | - Alban Zarzavadjian Le Bian
- Department of Digestive Surgery and Surgical Oncology, Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Paris XIII, Bobigny, France
| |
Collapse
|
5
|
Reynolds IS, Majeed MH, Soric I, Whelan M, Deasy J, McNamara DA. Endoscopic tattooing to aid tumour localisation in colon cancer: the need for standardisation. Ir J Med Sci 2016; 186:75-80. [PMID: 27645221 DOI: 10.1007/s11845-016-1502-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 09/10/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND/AIMS An increasing number of colon and rectal tumours are being resected using laparoscopic techniques. Identifying these tumours intraoperatively can be difficult. The use of tattooing can facilitate an easier resection; however, the lack of standardised guidelines can potentially lead to errors intraoperatively and potentially result in worse outcomes for patients. The aim of this study was to identify the most reliable method of preoperative tumour localisation from the available literature to date. METHODS A literature review was undertaken to identify any articles related to endoscopic tattooing and tumour localisation during colorectal surgery. RESULTS To date there is still mixed evidence regarding tattooing techniques and the choice of ink that should be used. There are numerous studies demonstrating safe tattooing techniques and highlighting the risks and benefits of different types of ink available. CONCLUSION Based on the available studies we have recommended a standardised approach to endoscopic tattooing of colorectal tumours prior to laparoscopic resection.
Collapse
Affiliation(s)
- I S Reynolds
- Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
| | - M H Majeed
- Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland
| | - I Soric
- Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland
| | - M Whelan
- Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland
| | - J Deasy
- Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland
| | - D A McNamara
- Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
| |
Collapse
|
6
|
Tumor Localization for Laparoscopic Colorectal Resection Without Endoscopic Tattooing. Surg Laparosc Endosc Percutan Tech 2016; 26:230-5. [DOI: 10.1097/sle.0000000000000257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
7
|
Mal'gina NV, Rodoman GV, Laberko LA, Razbirin VN, Gritskova IV, Epifanova SV, Dolgina TY. [Lipoma of Bauhin's valve - rare cause of large bowel obstruction]. Khirurgiia (Mosk) 2015:77-80. [PMID: 26978630 DOI: 10.17116/hirurgia20151177-80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|