Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea.
Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Surg Endosc. 2019 Apr;33(4):1080-1086. doi: 10.1007/s00464-018-6358-y. Epub 2018 Jul 12.
Preoperative localization is essential for minimally invasive colorectal surgery. However, conventional endoscopic tattooing agents such as India ink have safety issues. The availability of new endoscopic markers such as non-India-ink-based agent is limited. We assessed the efficacy and safety of preoperative endoscopic tattooing using autologous blood in colorectal surgery.
From February 2016, all patients who required localization of a target lesion before colorectal surgery underwent endoscopic tattooing using autologous blood, and the outcomes were collected prospectively. As a comparison, we retrospectively reviewed the medical records of a further 51 consecutive patients who underwent endoscopic tattooing using India ink before February 2016. A total of 102 patients who underwent endoscopic tattooing using either India ink or autologous blood were included in this study. The primary outcomes were the visibility of the tattooing in the peritoneal cavity and related adverse events.
Endoscopic tattoos produced using India ink were visible in 49 (96.1%) patients, and tattoos created using autologous blood were visible in 47 (92.2%) patients. In the autologous blood group, the tattoo could not be identified in four patients due to excessive peritoneal fat, bleeding tendency, congenital anomaly, and suboptimal tattooing. Seven (13.7%) patients in the India ink group and three (5.9%) patients in the autologous blood group experienced endoscopic tattooing-related adverse events.
Autologous blood is a feasible and safe tattooing agent for preoperative endoscopic localization of colorectal lesions within maximal interval of 5 days.
微创结直肠手术需要进行术前定位。然而，传统的内镜纹身剂（如印度墨水）存在安全问题，新型的内镜标记物（如非印度墨水基制剂）的可用性有限。我们评估了在结直肠手术中使用自体血进行术前内镜纹身的效果和安全性。
自 2016 年 2 月起，所有需要在结直肠手术前定位目标病变的患者均接受了自体血内镜纹身，前瞻性地收集了结果。作为比较，我们回顾性地分析了 2016 年 2 月前接受印度墨水内镜纹身的另外 51 例连续患者的病历。本研究共纳入了 102 例接受印度墨水或自体血内镜纹身的患者。主要结局是腹膜腔内纹身的可见性和相关不良事件。
使用印度墨水制作的内镜纹身 49 例（96.1%）可见，使用自体血制作的纹身 47 例（92.2%）可见。在自体血组中，由于腹膜脂肪过多、出血倾向、先天异常和纹身效果不佳，有 4 例患者无法识别纹身。印度墨水组中有 7 例（13.7%）患者和自体血组中有 3 例（5.9%）患者发生与内镜纹身相关的不良事件。
自体血是一种可行且安全的纹身剂，可用于术前定位结直肠病变，最大间隔时间为 5 天。
