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.
Similar content being viewed by others
References
Wang CL, Qu G, Xu HW (2014) The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis. Int J Colorectal Dis 29(3):309–320
Solon JG, Al-Azawi D, Hill A et al (2010) Colonoscopy and computerized tomography scan are not sufficient to localize right-sided colonic lesions accurately. Colorectal Dis 12(10 Online):e267–e272. doi:10.1111/j.1463-1318.2009.02144.x
Vignati P, Welch JP, Cohen JL (1994) Endoscopic localization of colon cancers. Surg Endosc 8:1085–1087
Dunaway MT, Webb WR, Rodning CB (1988) Intraluminal measurement of distance in the colorectal region employing rigid and flexible endoscopes. Surg Endosc 2(2):81–83
Askin MP, Waye JD, Fiedler L et al (2002) Tattoo of colonic neoplasms in 113 patients with a new sterile carbon compound. Gastrointest Endosc 56(3):339–342
Ellis KK, Fennerty MB (1997) Marking and identifying colon lesions. Tattoos, clips, and radiology in imaging the colon. Gastrointest Endosc Clin N Am 7(3):401–411
Tatsuno B, Murariu D, Bergmann L et al (2012) Novel technique for preoperative localization of colorectal tumors for laparoscopic resection. Surg Laparosc Endosc Percutan Tech 22(5):e281–e283. doi:10.1097/SLE.0b013e31825b3aaa
Tabibian N, Michaletz PA, Schwartz JT et al (1998) Use of an endoscopically placed clip can avoid diagnostic errors in colonoscopy. Gastrointest Endosc 34(3):262–264
Park JW, Sohn DK, Hong CW et al (2008) The usefulness of preoperative colonoscopic tattooing using a saline test injection method with prepackaged sterile India ink for localization in laparoscopic colorectal surgery. Surg Endosc 22(2):501–505. doi:10.1007/s00464-007-9495-2
Gorgun IE, Aytac E, Manilich E et al (2013) Intraoperative colonoscopy does not worsen the outcomes of laparoscopic colorectal surgery: a case-matched study. Surg Endosc 27(10):3572–3576
Aboosy N, Mulder CJ, Berends FJ et al (2005) Endoscopic tattoo of the colon might be standardized to locate tumors intraoperatively. Rom J Gastroenterol 14(3):245–248
Elarini T, Wexner SD, Isenberg GA (2015) The need for standardization of colonoscopic tattooing of colonic lesions. Dis Colon Rectum 58(2):264–267
Hyong-Ju K, Bo-In L, Byung-Wook K et al (2006) Potential cancer cell inoculation of tattoo site through use of a contaminated needle. Gastrointest Endosc 63:884–886
Yeung JMC, Maxwell-Armstrong C, Acheson AG (2009) Colonic tattooing in laparoscopic surgery—making the mark? Colorectal Dis 11(5):527–530
Raju GS (2001) Double injection technique to prevent complications of endoscopic tattooing. Gastrointest Endosc 53:697–698
Bretagne JF, Manfredi S, Piette C et al (2010) Yield of high-grade dysplasia based on polyp size detected at colonoscopy: a series of 2295 examinations following a positive fecal occult blood test in a population-based study. Dis Colon Rectum 53(3):339–345
Zafar A, Mustafa M, Chapman M (2012) Colorectal polyps: when should we tattoo? Surg Endosc 26(11):3264–3266
Ponsky JL, King JF (1975) Endoscopic marking of colonic lesions. Gastrointest Endosc 22(1):42–43
Shatz BA, Weinstock LB, Swanson PE et al (1997) Long-term safety of India ink tattoos in the colon. Gastrointest Endosc 45(2):153–156
Salomon P, Berner JS, Waye JD (1993) Endoscopic India ink injection: a method for preparation, sterilization, and administration. Gastrointest Endosc 39(6):803–805
Holland S (1994) Sterility of India ink. Gastrointest Endosc 40(4):519–520
Waye JD (1994) Response letter to sterility of India ink. Gastrointest Endosc 40(4):520
Botoman VA, Pietro M, Thirlby RC (1994) Localization of colonic lesions with endoscopic tattoo. Dis Colon Rectum 37(8):775–776
Coman E, Brandt LJ, Brenner S et al (1991) Fat necrosis and inflammatory pseudotumor due to endoscopic tattooing of the colon with India ink. Gastrointest Endosc 37(1):65–68
Park SI, Genta RS, Romeo DP et al (1991) Colonic abscess and focal peritonitis secondary to India ink tattooing of the colon. Gastrointest Endosc 37(1):68–71
Snider TE, Goodell WM, Pulitzer DR (1994) Gastrointestinal tattoos. Arch Pathol Lab Med 118(6):640–641
McArthur CS, Roayaie S, Waye JD (1999) Safety of preoperation endoscopic tattoo with India ink for identification of colonic lesions. Surg Endosc 13(4):397–400
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Funding
There was no source of funding for this article.
Conflict of interest
Ian Reynolds declares that he has no conflict of interest, Muhammad Hamid Majeed declares that he has no conflict of interest, Igor Soric declares that he has no conflict of interest, Maria Whelan declares that she has no conflict of interest, Joseph Deasy declares that he has no conflict of interest and Deborah McNamara declares that she has no conflict of interest.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent
Informed consent was obtained by the patient whose pictures are included in this study.
Rights and permissions
About this article
Cite this article
Reynolds, I.S., Majeed, M.H., Soric, I. et al. Endoscopic tattooing to aid tumour localisation in colon cancer: the need for standardisation. Ir J Med Sci 186, 75–80 (2017). https://doi.org/10.1007/s11845-016-1502-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-016-1502-y