Yerdel Mehmet Ali, Özgen Görkem
İstanbul Bariatrics, Obesity Center, İstanbul, Turkey.
Surg Laparosc Endosc Percutan Tech. 2018 Dec;28(6):e106-e108. doi: 10.1097/SLE.0000000000000553.
In contrast to colonic tattooing, data on dye-marking before gastric operations are scarce. A simple method of gastric tattooing before sleeve gastrectomy (SG) is presented. SG, under tattoo guidance has never been reported. Submucosa of the lesion is injected with 1 to 2 mL of carbon particles (Spot, PA) 24 hours before SG. At surgery, serosal dye stain is identified and stapling achieved with care to remove all dye-stained segment. Dye spread on the serosal surface differed significantly. However, as all the dye-stained segments were avoidable during stapling, 2 neuroendocrine tumors, 2 leiomyomas, and 1 benign ulcer were resected with clear histologic margins. The method presented herein may decrease the need for operative gastroscopy, mucosal resection, or laparoscopic gastrotomy in a number of patients. Because of the problem of the dye spreading, its utilization may be inappropriate in lesions that are closer to the minor curvature and incisura angularis in particular.
与结肠纹身不同，关于胃部手术前染料标记的数据很少。本文介绍了一种在袖状胃切除术（SG）前进行胃部纹身的简单方法。在纹身引导下进行SG此前从未有过报道。在SG前24小时，向病变黏膜下层注射1至2毫升碳颗粒（Spot，PA）。手术时，识别浆膜染料染色，并小心进行吻合以切除所有被染料染色的部分。染料在浆膜表面的扩散差异很大。然而，由于在吻合过程中所有被染料染色的部分都可以避开，2例神经内分泌肿瘤、2例平滑肌瘤和1例良性溃疡均在组织学切缘清晰的情况下被切除。本文介绍的方法可能会减少许多患者进行术中胃镜检查、黏膜切除或腹腔镜胃切开术的需求。由于染料扩散的问题，特别是对于靠近胃小弯和角切迹的病变，该方法的应用可能不合适。
