Askin Matthew P, Waye Jerome D, Fiedler Lawrence, Harpaz Noam
Division of Gastroenterology, Mount Sinai Medical Center, New York, New York, USA.
Gastrointest Endosc. 2002 Sep;56(3):339-42. doi: 10.1016/s0016-5107(02)70035-7.
Endoscopic marking of intestinal lesions is essential when difficulty is anticipated with subsequent localization during surgical resection or postpolypectomy surveillance. The most commonly used indelible marker has been India ink, which must be diluted and sterilized, a cumbersome process. SPOT, a prepackaged, sterile Food and Drug Administration-approved formulation of pure carbon particles in suspension, eliminates the need for preinjection preparation.
Ten patients with colonic polyps deemed endoscopically unresectable or malignant-appearing had the area surrounding the lesions injected with SPOT and subsequently underwent surgical resection. An additional 103 patients underwent colonoscopic injection with SPOT and were followed endoscopically or underwent surgery at another hospital.
The SPOT injection sites were visible to the surgeons in all 10 cases. On histopathologic evaluation, none of the resection specimens exhibited necrosis or abscess formation. In total, there were 118 SPOT injections in 113 patients; none had fever, abdominal pain, or any other signs or symptoms of inflammation develop. In the nonoperated group, 42 patients subsequently underwent colonoscopies at our institution, and in all cases stains were readily identifiable at the injection sites.
SPOT is a safe and effective marker for use at colonoscopy when surgical resection is anticipated. It is also useful for endoscopic follow-up of patients who have not undergone surgery.
当预计在手术切除或息肉切除术后监测期间后续定位存在困难时，肠道病变的内镜标记至关重要。最常用的不可擦除标记物是印度墨水，其必须稀释和消毒，过程繁琐。SPOT是一种预先包装的、经美国食品药品监督管理局批准的无菌悬浮液纯碳颗粒制剂，无需注射前准备。
10例经内镜检查认为无法切除或疑似恶性的结肠息肉患者，在病变周围区域注射SPOT，随后接受手术切除。另外103例患者接受了SPOT结肠镜注射，并在内镜下随访或在另一家医院接受手术。
在所有10例病例中，外科医生均可见SPOT注射部位。经组织病理学评估，所有切除标本均未出现坏死或脓肿形成。113例患者共进行了118次SPOT注射；无一例出现发热、腹痛或任何其他炎症体征或症状。在未手术组中，42例患者随后在我们机构接受了结肠镜检查，所有病例中注射部位的染色均易于识别。
当预计进行手术切除时，SPOT是一种用于结肠镜检查的安全有效的标记物。它对于未接受手术的患者的内镜随访也很有用。
