Zeitschrift für klinische Studien
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Preoperative Localization of Colorectal Tumors with Endoscopic Tattooing for Laparoscopic Surgery

Ibrahim-Abdelaziz D, Monzur F, Abdi T, Jackson P and Haddad N

Background: Effective localization of colorectal tumors with a visible marker is necessary for adequate resection in laparoscopic surgery. Tattooing of these tumors by endoscopy is a widely utilized method for proper localization.

Methods: A retrospective study of 50 patients who underwent tattooing with colonoscopy prior to colorectal surgery over a 12-year period was conducted. One patient was excluded from analysis due to incomplete data. Tattooing was performed using SPOT endoscopic marker (GI Supply, Camp Hill, PA), which is a prepackaged biocompatible agent containing highly purified, very fine carbon particles.

Results: 49 patients received endoscopic tattooing with colonoscopy. Of these 49 patients, 37 patients had tattooing identified in either surgery and/or surgical pathology specimens. 12 lesions were not identified on both surgery and pathology. No tattoo related complications were noted. There were no conversions from laparoscopic to open surgical resection due to poorly visualized tattooed lesions. No patients underwent intra-operative colonoscopy to confirm accurate tattoo placement.

Conclusions: All colonic lesions that appear to be malignant should be tattooed during endoscopy to improve surgical localization. Tattoo endoscopy is a safe and effective method for preoperative tumor localization.