Annals of Coloproctology

Original Articles

Minimally invasive surgery

Preoperative localization of potentially invisible colonic lesions on the laparoscopic operation field: using autologous blood tattooing: Ji Yeon Mun, Hyunjoon An, Ri Na Yoo, Hyeon-Min Cho, Bong-Hyeon Kye; Ann Coloproctol. 2024;40(3):225-233. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2023.00059.0008

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Graphical Abstract Abstract PDF: Purpose
Preoperative colonoscopic (POC) localization is recommended for patients scheduled for elective laparoscopic colectomy for early colon cancer. Among the various localization method, POC tattooing localization has been widely used. Several dyes have been used for tattooing, but dye has disadvantages, including foreign body reactions. For this reason, we have used autologous blood tattooing for POC localization. This study aimed to evaluate the safety and efficacy of the autologous blood tattooing method.
Methods
This study included patients who required POC localization of the colonic neoplasm among the patients who were scheduled for elective colon resection. The indication for localization was early colon cancer (clinically T1 or T2) or colonic neoplasms that could not be resected endoscopically. POC autologous blood tattooing was performed after saline injection, and 2 hemoclips were applied.
Results
A total of 45 patients who underwent autologous blood tattooing and laparoscopic colectomy were included in this study. All POC localization sites were visible in the laparoscopic view. POC localization sites showed almost perfect agreement with intraoperative surgical findings. There were no complications like bowel perforation, peritonitis, hemoperitoneum, and mesenteric hematoma.
Conclusion
Autologous blood is a safe and effective agent for localizing materials that can replace previous dyes. However, a large prospective case-control study is required for the routine application of this procedure in early colon cancer or colonic neoplasms.

Preoperative endoscopic tattoo marking improves lymph node retrieval in laparoscopic rectal resection: a retrospective cohort study: Kouki Imaoka, Takuya Yano, Masanori Yoshimitsu, Sotaro Fukuhara, Ko Oshita, Kanyu Nakano, Masaki Kunihiro, Hitoshi Idani, Masazumi Okajima; Ann Coloproctol. 2023;39(2):115-122. Published online September 16, 2021; DOI: https://doi.org/10.3393/ac.2021.00458.0065

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Graphical Abstract Abstract PDF

Purpose
Harvesting at least 12 lymph nodes (LNs) is recommended for adequate tumor staging in colon surgery. Although preoperative endoscopic tattooing has been used for primary localization of tumors, its impact on LN retrieval in colorectal surgery remains controversial. We aimed to investigate the relationship between preoperative tattooing and LN retrieval after laparoscopic rectal resection.
Methods
We reviewed the records of 92 patients with rectal cancer who underwent laparoscopic resection from January 1, 2018 to December 31, 2019. Patients were categorized into 2 groups according to whether preoperative endoscopic tattooing was performed. The rate of adequate LN retrieval (≥12) was compared.
Results
The tattooed and non-tattooed groups comprised 49 and 43 patients, respectively. In the tattooed and non-tattooed groups, the rates of adequate LN retrieval were 75.5% and 55.8%, respectively (P=0.046). Univariate analysis revealed that female sex, tattooing, LN metastasis status, pathological pathological stage (p-stage), and LN dissection were predictive factors for adequate LN retrieval. In the multivariate analysis, female sex (odds ratio [OR], 3.34; 95% confidence interval [CI], 1.15–9.73; P=0.027), tattooing (OR, 2.87; 95% CI, 1.03–7.94; P=0.043), and p-stage (OR, 3.34; 95% CI, 1.04–10.75; P=0.043) were independent predictive factors for adequate LN retrieval after surgery.
Conclusion
This study revealed that preoperative endoscopic tattooing was statistically significantly associated with adequate LN retrieval in patients with rectal cancer who underwent laparoscopic rectal resection. Preoperative endoscopic tattooing should be considered to improve disease assessment and avoid stage migration.

Citations

Citations to this article as recorded by

To what extent does endoscopic tattooing marking boost lymph node retrieval?
Won Beom Jung
Annals of Coloproctology.2023; 39(2): 95. CrossRef
The effect of preoperative endoscopic tattooing on lymph node retrieval in colorectal cancer: a systematic review and meta-analysis
Mohamad Nawras, Karan Chawla, Armelle DeRiso, Christina Dubchuk, Azizullah Beran, Muhammad Aziz, Stephanie M. Pannell
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. CrossRef
Association between the number of retrieved lymph nodes and demographic/tumour-related characteristics in colorectal cancer: a systematic review and meta-analysis
Qianqian Liu, Min Huang, Jing Yang, Mengyuan Jiang, Ziru Zhao, Haitong Zhao, Tingting He, Yuping Bai, Rui Zhang, Min Zhang
BMJ Open.2023; 13(12): e072244. CrossRef

Review

Malignant disease, Rectal cancer,Colorectal cancer,Biomarker & risk factor

Multifunctional Indocyanine Green Applications for Fluorescence-Guided Laparoscopic Colorectal Surgery: Gyung Mo Son, Hong-min Ahn, In Young Lee, Gi Won Ha; Ann Coloproctol. 2021;37(3):133-140. Published online June 9, 2021; DOI: https://doi.org/10.3393/ac.2021.05.07

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39 Citations

Abstract PDF

Indocyanine green (ICG) could be applied for multiple functions such as fluorescent tumor localization, fluorescence lymph node mapping (FLNM), and intraoperative angiography in colorectal cancer surgery. With the near-infrared (NIR) systems, colonoscopic ICG tattooing can be used to define the early colorectal cancer that cannot be easily distinguished through the serosal surface. The lymphatic pathways can be visualized under the NIR system when ICG is injected through the submucosal or subserosal layer around the tumor. Intraoperative ICG angiography can be applied to find a favorable perfusion segment before the colon transection. Although all fluorescence functions are considered essential steps in image-guided surgery, it is difficult to perform multifunctional ICG applications in a single surgical procedure at once because complex protocols could interfere with each other. Therefore, we review the multifunctional ICG applications for fluorescent tumor localization, FLNM, and ICG angiography. We also discuss the optimal protocol for fluorescence-guided colorectal surgery.

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Katharina Lucas, Nathaniel Melling, Anastasios D. Giannou, Matthias Reeh, Oliver Mann, Thilo Hackert, Jakob R. Izbicki, Daniel Perez, Julia K. Grass
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Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
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Original Articles

Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery: Sang Jae Lee, Dae Kyung Sohn, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jae Hwan Oh; Ann Coloproctol. 2018;34(4):206-211. Published online July 26, 2018; DOI: https://doi.org/10.3393/ac.2017.09.25

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17 Citations

Abstract PDF

Purpose
The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery.
Methods
Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing.
Results
The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred.
Conclusion
Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.

Citations

Citations to this article as recorded by

Indocyanine Green Tattooing During Colonoscopy as a Guide to Laparoscopic Colorectal Cancer Surgery: A Literature Review
Marzia Varanese, Stefano Arcieri, Augusto Lauro, Cristina Panetta, Chiara Eberspacher, Rossella Palma, Domenico Mascagni, Stefano Pontone
Surgical Innovation.2024; 31(1): 103. CrossRef
Indocyanine-coated fluorescent clips for localization of gastrointestinal tumors
Kyonglin Park, Hongrae Kim, Hyoung-Jun Kim, Yongdoo Choi, Sung-Jae Park, Jae-Suk Park, Min-Kyu Choi, Dae Kyung Sohn
Journal of Innovative Medical Technology.2024; 2(1): 20. CrossRef
Preoperative localization of potentially invisible colonic lesions on the laparoscopic operation field: using autologous blood tattooing
Ji Yeon Mun, Hyunjoon An, Ri Na Yoo, Hyeon-Min Cho, Bong-Hyeon Kye
Annals of Coloproctology.2024; 40(3): 225. CrossRef
A Green Lantern for the Surgeon: A Review on the Use of Indocyanine Green (ICG) in Minimally Invasive Surgery
Pietro Fransvea, Michelangelo Miccini, Fabio Rondelli, Giuseppe Brisinda, Alessandro Costa, Giovanni Maria Garbarino, Gianluca Costa
Journal of Clinical Medicine.2024; 13(16): 4895. CrossRef
Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery
Zoe Garoufalia, Steven D. Wexner
Journal of Clinical Medicine.2023; 12(2): 494. CrossRef
Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature
Michael K. Konstantinidis, Argyrios Ioannidis, Panteleimon Vassiliu, Nikolaos Arkadopoulos, Ioannis S. Papanikolaou, Konstantinos Stavridis, Gaetano Gallo, Dimitrios Karagiannis, Manish Chand, Steven D. Wexner, Konstantinos Konstantinidis
Frontiers in Surgery.2023;[Epub] CrossRef
Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial
Ke-hui Zhang, Jing-ze Li, Hai-bin Zhang, Ren-hao Hu, Xi-mao Cui, Tao Du, Liang Zheng, Shun Zhang, Chun Song, Mei-dong Xu, Xiao-hua Jiang
BMC Cancer.2023;[Epub] CrossRef
Indocyanine Green tattooing for marking the caudal excision margin of a full-thickness vaginal endometriotic nodule
S Khazali, B Mondelli, K Fleischer, M Adamczyk
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Indocyanine green dye and its application in gastrointestinal surgery: The future is bright green
Zavier Yongxuan Lim, Swetha Mohan, Sunder Balasubramaniam, Saleem Ahmed, Caroline Ching Hsia Siew, Vishal G Shelat
World Journal of Gastrointestinal Surgery.2023; 15(9): 1841. CrossRef
Tumor Segmentation in Colorectal Ultrasound Images Using an Ensemble Transfer Learning Model: Towards Intra-Operative Margin Assessment
Freija Geldof, Constantijn W. A. Pruijssers, Lynn-Jade S. Jong, Dinusha Veluponnar, Theo J. M. Ruers, Behdad Dashtbozorg
Diagnostics.2023; 13(23): 3595. CrossRef
Fluorescence Imaging in Colorectal Surgery: An Updated Review and Future Trends
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Promising Novel Technique for Tumor Localization in Laparoscopic Colorectal Surgery Using Indocyanine Green-Coated Endoscopic Clips
Dong Woon Lee, Dae Kyung Sohn, Kyung Su Han, Chang Won Hong, Hyoung Chul Park, Jae Hwan Oh
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Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
Jeffrey Dalli, Eamon Loughman, Niall Hardy, Anwesha Sarkar, Mohammad Faraz Khan, Haseeb A. Khokhar, Paul Huxel, Donal F. O’Shea, Ronan A. Cahill
Scientific Reports.2021;[Epub] CrossRef
Endoscopic Preoperative Tattooing and Marking in the Gastrointestinal Tract: A Systematic Review of Alternative Methods
Manuel Barberio, Margherita Pizzicannella, Giovanni Guglielmo Laracca, Mahdi Al-Taher, Andrea Spota, Jacques Marescaux, Eric Felli, Michele Diana
Journal of Laparoendoscopic & Advanced Surgical Techniques.2020; 30(9): 953. CrossRef
The Usefulness of Preoperative Colonoscopic Tattooing with Autologous Blood for Localization in Laparoscopic Colorectal Surgery
Ui Do Yeo, Nak Song Sung, Seung Jae Roh, Won Jun Choi, Kyung Ho Song, In Seok Choi, Dae Sung Yoon, Sang Eok Lee, Ju Ik Moon, Seong Uk Kwon, In Eui Bae, Seung Jae Lee
The Journal of Minimally Invasive Surgery.2020; 23(3): 114. CrossRef
Preoperative Colonoscopic Tattooing Using a Direct Injection Method with Indocyanine Green for Localization of Colorectal Tumors: An Efficacy and Safety Comparison Study
Young Jin Kim, Ji Won Park, Han-Ki Lim, Yoon-Hye Kwon, Min Jung Kim, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
The Journal of Minimally Invasive Surgery.2020; 23(4): 186. CrossRef
Robotic excision of a colonic neoplasm with ICG as a tumor localizer and colonoscopic assistance
S. Atallah, A. Oldham, A. Kondek, S. Larach
Techniques in Coloproctology.2019; 23(6): 573. CrossRef

Preoperative Localization of Early Colorectal Cancer or a Malignant Polyp by Using the Patient's Own Blood: Seung Hwan Lee, Do Yoon Kim, Seung Yeop Oh, Kwang Jae Lee, Kwang Wook Suh; Ann Coloproctol. 2014;30(3):115-117. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.115

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14 Citations

Abstract PDF

Purpose

Preoperative localization is the most important preparation for laparoscopic surgery. Preoperative marking with India ink has widely been used and is considered to be safe and effective. However, India ink can cause significant inflammation, adhesions and bowel obstruction. Therefore, we have used the patient's blood instead of the ink since 2011. In this retrospective study, we wanted to examine the feasibility of preoperative localization by using the patient's blood.

Methods

Twenty-five patients who underwent preoperative localization in which 10 mL of their own venous blood was used as a tattooing agent were included in this study. The characteristics of the patients, the anatomy of the colon cancer, and the efficacy and the side effects of using this procedure were analyzed.

Results

In 23 cases (92%), through the laparoscope, we found perfectly localized bloody smudges in the serosa. However, in 2 cases (8%), we could not find the exact location of the lesion. No patients showed any complications.

Conclusion

Preoperative localization of early colon cancer or a malignant polyp by using patient's blood is feasible, safe and simple. We think that using the patient's blood for localization of a lesion is better than using some other foreign material such as India ink.

Citations

Citations to this article as recorded by

Safety and efficacy of autologous blood tattooing for preoperative colonic localization: a comparative study with conventional India ink tattooing
Hyeon Kyeong Kim, Ho Seung Kim, Jin Hoon Nam, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Gyoung Tae Noh
Techniques in Coloproctology.2024;[Epub] CrossRef
Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial
Ke-hui Zhang, Jing-ze Li, Hai-bin Zhang, Ren-hao Hu, Xi-mao Cui, Tao Du, Liang Zheng, Shun Zhang, Chun Song, Mei-dong Xu, Xiao-hua Jiang
BMC Cancer.2023;[Epub] CrossRef
Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature
Michael K. Konstantinidis, Argyrios Ioannidis, Panteleimon Vassiliu, Nikolaos Arkadopoulos, Ioannis S. Papanikolaou, Konstantinos Stavridis, Gaetano Gallo, Dimitrios Karagiannis, Manish Chand, Steven D. Wexner, Konstantinos Konstantinidis
Frontiers in Surgery.2023;[Epub] CrossRef
Autologous blood for preoperative colorectal TUMOR's localization: A Vietnamese preliminary experience
Ngoc Hung Nguyen, The Hiep Nguyen, Cong Long Nguyen, Xuan Vinh Vu, Tuan Hiep Luong, Thanh Khiem Nguyen
Annals of Medicine & Surgery.2022;[Epub] CrossRef
Preoperative tumor marking with indocyanine green prior of robotic colorectal resections
Michael K. Konstantinidis, Argyrios Ioannidis, Pantelis Vasiliou, Nikolaos Arkadopoulos, Ioannis S. Papanikolaou, Manish Chand, Tom Pampiglione, Dimitrios Karagiannis, Konstantinos Konstantinidis
Frontiers in Surgery.2022;[Epub] CrossRef
A Precise Lesion Localization System Using a Magnetometer With Real-Time Baseline Cancellation for Laparoscopic Surgery
Soon-Jae Kweon, Woojin Yun, Hyunwoo Park, Jeong-Ho Park, Jung Hoon Lee, Jin Lee, Minkyu Je, Sohmyung Ha, Choul-Young Kim
IEEE Access.2021; 9: 131648. CrossRef
Endoscopic Preoperative Tattooing and Marking in the Gastrointestinal Tract: A Systematic Review of Alternative Methods
Manuel Barberio, Margherita Pizzicannella, Giovanni Guglielmo Laracca, Mahdi Al-Taher, Andrea Spota, Jacques Marescaux, Eric Felli, Michele Diana
Journal of Laparoendoscopic & Advanced Surgical Techniques.2020; 30(9): 953. CrossRef
The Usefulness of Preoperative Colonoscopic Tattooing with Autologous Blood for Localization in Laparoscopic Colorectal Surgery
Ui Do Yeo, Nak Song Sung, Seung Jae Roh, Won Jun Choi, Kyung Ho Song, In Seok Choi, Dae Sung Yoon, Sang Eok Lee, Ju Ik Moon, Seong Uk Kwon, In Eui Bae, Seung Jae Lee
The Journal of Minimally Invasive Surgery.2020; 23(3): 114. CrossRef
Preoperative Colonoscopic Tattooing with Autologous Blood in Laparoscopic Colorectal Cancer Surgery: Red-Flagging for an Invisible Enemy
Jeehye Lee, Heung-Kwon Oh
The Journal of Minimally Invasive Surgery.2020; 23(3): 110. CrossRef
Autologous blood, a novel agent for preoperative colonic localization: a safety and efficacy comparison study
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, Won-Suk Lee
Surgical Endoscopy.2019; 33(4): 1080. CrossRef
Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery
Sang Jae Lee, Dae Kyung Sohn, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jae Hwan Oh
Annals of Coloproctology.2018; 34(4): 206. CrossRef
Preoperative localization of colorectal cancer: a systematic review and meta-analysis
Sergio A. Acuna, Maryam Elmi, Prakesh S. Shah, Natalie G. Coburn, Fayez A. Quereshy
Surgical Endoscopy.2017; 31(6): 2366. CrossRef
Colonoscopic Tattooing of Colonic Lesions
Jae Hyun Kim, Won Ho Kim
The Korean Journal of Gastroenterology.2015; 66(4): 190. CrossRef
Efficacy of a Patient's Own Blood as Colonic Localization Agent
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Annals of Coloproctology.2014; 30(3): 101. CrossRef

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