Study on clinical value of three localization methods in laparoscopic colorectal tumor surgery / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery
; (12): 628-631, 2013.
Article
in Zh
| WPRIM
| ID: wpr-357174
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effectiveness of three localization methods, including methylene blue, metal clips and intraoperative colonoscopy in laparoscopic colorectal surgery.</p><p><b>METHODS</b>A retrospective analysis was performed to review the clinical data of 64 patients who underwent the laparoscopic colorectal operations in Cancer Hospital of Fudan University from December 2009 to June 2012. Three methods of tumor localization were used perioperatively, including 23 cases of methylene blue, 20 of metal clips and 21 of colonoscopy.</p><p><b>RESULTS</b>Operations were successfully performed in this cohort and there were no deaths or complications. In methylene blue group, intraoperative colonoscopy was performed in two cases because of the inability to visualize blue dye on the serosal surface of the intestinal wall, another 2 cases were converted to open operation because of methylene blue diffusion and inability to identify resection margin. Intraoperative colonoscopic localization was required for 3 cases of sigmoid colon or upper rectal tumor because of inaccurate tumor localization by metal clips. Poor operative exposure due to obvious bowel distension prompted the conversion to open surgery in 2 cases of colonoscopy localization group, and the accurate position of the lesion was not found in another 2 cases due to long pedunculated adenoma.</p><p><b>CONCLUSIONS</b>Colorectal tumor can be localized effectively by endoscopic methylene blue tattooing at a maximum of 2 tumors before operation and the method of 4-point positioning can significantly improve the accuracy of colorectal tumor localization. Tumor localization preoperatively on the day of surgery by metal clip is accurate for the right or left colon cancer. Intraoperative colonoscopy can localize tumor accurately and rapidly for rectosigmoid or descending tumor, and the incidence of bowel distension can be significantly reduced. Localization method should be considered according to the tumor location and surgical procedure.</p>
Full text:
1
Index:
WPRIM
Main subject:
General Surgery
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Colorectal Neoplasms
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Retrospective Studies
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Treatment Outcome
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Laparoscopy
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Methods
Type of study:
Observational_studies
Limits:
Adult
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Aged
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Female
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Humans
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Male
Language:
Zh
Journal:
Chinese Journal of Gastrointestinal Surgery
Year:
2013
Type:
Article