Detailed Information

Cited 0 time in webofscience Cited 88 time in scopus
Metadata Downloads

Perioperative tumor localization for laparoscopic colorectal surgery

Authors
Kim S.H.Milsom J.W.Church J.M.Ludwig K.A.Garcia-Ruiz A.Okuda J.Fazio V.W.
Issue Date
1997
Publisher
Springer New York
Keywords
Colon tumors; Laparoscopic surgery; Rectal tumors; Tumor localization
Citation
Surgical Endoscopy, v.11, no.10, pp.1013 - 1016
Indexed
SCOPUS
Journal Title
Surgical Endoscopy
Volume
11
Number
10
Start Page
1013
End Page
1016
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/25661
DOI
10.1007/s004649900514
ISSN
0930-2794
Abstract
Background: Because of the inability to palpate colonic tumors during laparoscopy, their location must be precisely identified before resection is undertaken. Method: A retrospective study was performed of 58 patients in order to be able to describe our methods of tumor localization for laparoscopic colorectal operations and to review their effectiveness. Results: In all patients, the entire colon was examined preoperatively by colonoscopy. In one patient, preoperative colonoscopic localization was inaccurate. In 31 patients, tumors were easily detectable at surgery. In five patients with the tumor in the right colon, even though the lesion was not detectable at surgery, right colectomy was performed without marking because preoperative colonoscopy reliably identified the lesion adjacent to the ileocecal valve. Twentytwo patients required some type of procedure to localize the tumor. The procedures and their problems were as follows: preoperative tattoo (five) - tattoo not visualized (one); intraoperative colonoscopy alone (six), combined with intraoperative tattoo (four) or clip (three) - poor operative exposure due to bowel distension (nine), hard to see the clip (three), dislodged clip (two), inadequate resection margin (one); intraoperative proctoscopy alone (two), combined with laparoscopic stitch (two) - no problems. In no patient was tumor present at a resection line and in no patient was the wrong segment resected. Conclusions: Reliable preoperative identification of the tumor adjacent to the ileocecal valve can permit right colectomy without marking. Lesions in the upper rectum can be approached via intraoperative proctoscopy ± suture placement. If the surgeon anticipates intraoperative localization may be difficult, lesions other than rectal or cecal ones should probably be marked by preoperative tattooing. Further studies regarding the technique of tattooing are warranted.
Files in This Item
There are no files associated with this item.
Appears in
Collections
2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles

qrcode

Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.

Altmetrics

Total Views & Downloads

BROWSE