Autologous blood, a novel agent for preoperative colonic localization: a safety and efficacy comparison study
- 221 Downloads
Preoperative localization is essential for minimally invasive colorectal surgery. However, conventional endoscopic tattooing agents such as India ink have safety issues. The availability of new endoscopic markers such as non-India-ink-based agent is limited. We assessed the efficacy and safety of preoperative endoscopic tattooing using autologous blood in colorectal surgery.
From February 2016, all patients who required localization of a target lesion before colorectal surgery underwent endoscopic tattooing using autologous blood, and the outcomes were collected prospectively. As a comparison, we retrospectively reviewed the medical records of a further 51 consecutive patients who underwent endoscopic tattooing using India ink before February 2016. A total of 102 patients who underwent endoscopic tattooing using either India ink or autologous blood were included in this study. The primary outcomes were the visibility of the tattooing in the peritoneal cavity and related adverse events.
Endoscopic tattoos produced using India ink were visible in 49 (96.1%) patients, and tattoos created using autologous blood were visible in 47 (92.2%) patients. In the autologous blood group, the tattoo could not be identified in four patients due to excessive peritoneal fat, bleeding tendency, congenital anomaly, and suboptimal tattooing. Seven (13.7%) patients in the India ink group and three (5.9%) patients in the autologous blood group experienced endoscopic tattooing-related adverse events.
Autologous blood is a feasible and safe tattooing agent for preoperative endoscopic localization of colorectal lesions within maximal interval of 5 days.
KeywordsColorectal neoplasia Endoscopy Tattooing Minimally invasive surgical procedures Laparoscopy
This research was supported by a Grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HI16C2319).
Compliance with ethical standards
Eui Joo Kim, Jun-Won Chung, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park, Duck Joo Choi, Sung Won Park, Jeong-Heum Baek, and Won-Suk Lee have no conflicts of interest or financial ties to disclose.
- 1.Park JW, Sohn DK, Hong CW, Han KS, Choi DH, Chang HJ, Lim SB, Choi HS, Jeong SY (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 22:501–505CrossRefGoogle Scholar
- 5.Hammond DC, Lane FR, Welk RA, Madura MJ, Borreson DK, Passinault WJ (1989) Endoscopic tattooing of the colon: an experimental study. Am Surg 55:457–461Google Scholar
- 7.Aboosy N, Mulder CJ, Berends FJ, Meijer JW, Sorge AA (2005) Endoscopic tattoo of the colon might be standardized to locate tumors intraoperatively. Rom J Gastroenterol 14:245–248Google Scholar
- 14.Sealed Envelope Ltd (2012) Power calculator for binary outcome non-inferiority trial. https://www.sealedenvelope.com/power/binary-noninferior/
- 15.World Health Organization Western Pacific Region International Association for the Study of Obesity International Obesity Task Force (2000) The Asia-Pacific perspective: redefining obesity and its treatment. WHO, GenevaGoogle Scholar
- 17.Hammond DC, Lane FR, Mackeigan JM, Passinault WJ (1993) Endoscopic tattooing of the colon: clinical experience. Am Surg 59:205–210Google Scholar
- 22.Nizam R, Siddiqi N, Landas SK, Kaplan DS, Holtzapple PG (1996) Colonic tattooing with India ink: benefits, risks, and alternatives. Am J Gastroenterol 91:1804–1808Google Scholar
- 23.Arteaga-Gonzalez I, Martin-Malagon A, Fernandez EM, Arranz-Duran J, Parra-Blanco A, Nicolas-Perez D, Quintero-Carrion E, Luis HD, Carrillo-Pallares A (2006) The use of preoperative endoscopic tattooing in laparoscopic colorectal cancer surgery for endoscopically advanced tumors: a prospective comparative clinical study. World J Surg 30:605–611CrossRefGoogle Scholar