Tumor Localization for Laparoscopic Colorectal Resection Without Endoscopic Tattooing

Abstract

Introduction: Tumor localization is a key step in laparoscopic colorectal surgery. Endoscopic tattooing is widely practiced with a satisfactory accuracy, whereas few studies have investigated its shortcomings. The aim of our study is to assess the accuracy and efficiency of a tumor localization protocol without endoscopic tattooing.

Methods: The tumor localization protocol was performed for 788 colorectal cancer/polyp patients undergoing laparoscopic colorectal resection. The localization accuracy was evaluated by the intraoperative exploration and the anatomopathologic results.

Results: The localization accuracy was 100% in our study. The drawbacks of endoscopic tattooing were overcome. Only 16.6% of the patients underwent preoperative endoscopic clip placement. Intraoperative colonoscopy was performed as a planned and purposive procedure instead of a remedial measurement. The misplacement of the camera port for laparoscopy was avoided in 18 cases (2.3%) guided by this protocol.

Conclusions: Colorectal tumor localization could be improved by this tumor localization protocol without endoscopic tattooing.