Tumor Localization for Laparoscopic Colorectal Surgery

World J Surg (2007) 31:1491–1495 DOI 10.1007/s00268-007-9082-7 Yong Beom Cho Æ Woo Yong Lee Æ Hae Ran Yun Æ Won Suk Lee Æ Seong Hyeon Yun Æ Ho-Kyung Chun Published online: 30 May 2007 Socie ´te ´ Internationale de Chirurgie 2007 Abstract endoscopic tattooing, and the other two underwent intraop- Background Because palpating colonic tumors during erative colonoscopy for localization. All lesions were cor- laparoscopy is impossible, the precise location of a tumor rectly localized by intraoperative colonoscopy. The accuracy must be identified before operation. The aim of this study of tumor localization was as follows: colonoscopy (180/203, was to evaluate the accuracy of various diagnostic methods 88.7%), barium enema (97/104, 93.3%), CT colonography that are used to localize colorectal tumors and to propose (89/94, 94.7%), endoscopic tattooing (94/96, 97.9%), and an adequate localization protocol for laparoscopic colo- intraoperative colonoscopy (4/4, 100%). rectal surgery. Conclusions With a combination of methods, localization Methods A total of 310 patients underwent laparoscopy- of tumors for laparoscopic surgery did not seem very dif- assisted colectomy between April 2000 and March 2006. ferent from that during open surgery. Preoperative endo- We investigated if the locations of the tumors that were scopic tattooing is a safe, highly effective method for estimated preoperatively were consistent with the actual localization. In the case of tattoo failure, intraoperative locations according to the operation. colonoscopy can be used for accurate localization. Results All the tumors were correctly localized and re- sected. Altogether, 203 patients had complete endoscopic Precise localization of tumors is a critical aspect of the reports available. Colonoscopy was inaccurate for tumor minimally invasive approach to colorectal surgery. The localization in 23 cases (11.3%). In total, 104 patients (33.5%)...