Zhang Shengyu, Wang Qiang, Feng Yunlu, Zhang Guannan, Chen Yang, Zheng Weiyang, Wu Xi, Yang Aiming
Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
Front Oncol. 2022 Feb 25;12:846900. doi: 10.3389/fonc.2022.846900. eCollection 2022.
Preoperative endoscopic markers have been extensively used for the localization of colonic neoplastic lesions in laparoscopic surgery. We conducted this respective cohort study to compare the localization accuracy of two commonly used endoscopic marker strategies (endoscopic clip plus abdominal plain film and endoscopic tattooing).
Patients who received preoperative colonoscopy localization for colonic neoplasia and underwent an elective laparoscopic operation afterward between 2013 and 2020 were included in this retrospective study. The localization accuracy of the two endoscopic strategies was compared, and the predictors of successful endoscopic localization were identified by multivariate regression.
In total, 195 patients [average age 62.4 ± 9.2 years, 123 male (63.1%)] undergoing preoperative colonoscopy localization and subsequent laparoscopic colectomy for colonic neoplasms were included. Endoscopic localization was finally proven to be successful in 150 (76.9%) patients in the surgery. Compared to the tattooing group, patients who had successful localization for colonic lesions were fewer in the clip group (64 of 101 cases, 63.4% vs. 86 of 94 cases, 91.5%, < 0.001). The multivariate regression analysis showed that the endoscopic tattooing strategy, endoscopic clip strategy, and lesion location were all predictors for successful localization (all with < 0.001).
Compared with endoscopic clip plus abdominal plain film, endoscopic tattooing had higher localization accuracy and less intraoperative colonoscopy counseling; the endoscopic clip strategy, tattooing strategy, and colonic lesion location were all predictors of successful endoscopic localization.
术前内镜标记物已广泛应用于腹腔镜手术中结肠肿瘤性病变的定位。我们进行了这项队列研究，以比较两种常用内镜标记策略（内镜夹加腹部平片和内镜纹身）的定位准确性。
本回顾性研究纳入了2013年至2020年间接受术前结肠镜检查定位结肠肿瘤并随后接受择期腹腔镜手术的患者。比较了两种内镜策略的定位准确性，并通过多因素回归确定了内镜定位成功的预测因素。
总共纳入了195例[平均年龄62.4±9.2岁，男性123例（63.1%）]接受术前结肠镜检查定位并随后因结肠肿瘤接受腹腔镜结肠切除术的患者。手术中最终证实150例（76.9%）患者内镜定位成功。与纹身组相比，夹子组结肠病变定位成功的患者较少（101例中的64例，63.4%对94例中的86例，91.5%，<0.001）。多因素回归分析显示，内镜纹身策略、内镜夹策略和病变位置均为定位成功的预测因素（均P<0.001）。
与内镜夹加腹部平片相比，内镜纹身具有更高的定位准确性且术中结肠镜咨询较少；内镜夹策略、纹身策略和结肠病变位置均为内镜定位成功的预测因素。
