Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy
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During laparoscopic gastrectomy, it is impossible to identify early gastric cancer (EGC) lesions; therefore, a precise localization technique is required. In this study, we evaluated a novel method of intraoperative portable abdominal radiograph for localization of EGC lesions after preoperative endoscopic clipping.
A retrospective study of 80 patients who had undergone laparoscopic gastrectomies with our intraoperative abdominal radiographic method of tumor localization was performed. During preoperative endoscopy, endoscopic metal clips were applied just proximal to the tumor. A plain abdominal radiograph taken immediately after oral administration of effervescent agents was employed to select candidates for intraoperative localization. Intraoperative vessel clips were laparoscopically applied along the greater and lesser curvatures, and a portable abdominal radiograph was taken to identify the location of endoscopic clips relative to laparoscopic vessel clips.
In all patients, endoscopic clips were applied proximal to the lesion without complications. Both intraluminally and extraluminally placed clips were successfully detected by intraoperative portable abdominal radiograph in all patients. Mean ± standard deviation (SD) proximal margin length was 34.2 ± 20.2 mm. All patients had tumor-free resection margin.
Preoperative endoscopic clipping and intraoperative portable abdominal radiograph is an accurate and simple tumor localization method in laparoscopic gastrectomy.
KeywordsStomach neoplasms Laparoscopy Abdominal radiograph Gastrectomy Endoscopy
Authors Hyoung-Il Kim, Woo Jin Hyung, Cho Rok Lee, Joon Seok Lim, Ji Yeong An, Jae-Ho Cheong, Seung Ho Choi, and Sung Hoon Noh have no conflicts of interest or financial ties to disclose.
- 12.Japanese Gastric Cancer A (1998) Japanese classification of gastric carcinoma, 2nd English edition. Gastric Cancer 1:10–24Google Scholar