Department of Digestive Surgery, Kawaguchi Municipal Medical Center, 180, Nishiaraijuku, Kawaguchi City, Saitama, 333-0833, Japan.
Int J Colorectal Dis. 2023 Aug 2;38(1):204. doi: 10.1007/s00384-023-04502-w.
Identifying tumor location is important in colorectal tumor resection. Preoperative endoscopic India ink marking is a widespread practice, but local injection of ink is an unstable procedure. Although it is often invisible, the ink may be sprayed into the peritoneal cavity and contaminate the surgical field. At our hospital, we introduced fluorescent clip marking (FCM) using the Zeoclip FS, an endoscopic clip developed using near-infrared fluorescent resin. We tested the usefulness of FCM by retrospectively comparing cases in which FCM was used with cases in which conventional ink marking was used.
We enrolled 305 patients with colorectal tumors who underwent colorectal surgery after preoperative marking from January 2017 to April 2022. We classified the patients into the FCM group (86 patients) and the India ink tattoo group (219 patients). Endoscopic marking was completed in the FCM group by the day before surgery, and fluorescence was evaluated during surgery with a fluorescent laparoscopic system. Patient backgrounds, marking visibility, adverse effects, and early postoperative results were retrospectively compared between groups.
Marking was visually confirmed in 80 patients in the FCM group (93.02%) and in 166 patients in the India ink tattoo group (75.80%) (p = 0.0006). In the group with India ink tattoos, contamination of the surgical field was observed in seven cases (3.20%). No adverse events were observed in the FCM group.
In colorectal surgery, FCM provides better visibility than the conventional India ink tattooing method and is a simple and safe marking method.
Examination of fluorescence navigation for laparoscopic colorectal cancer surgery. Research Ethics Committee of the Kawaguchi Municipal Medical Center (Saitama, Japan) approval number: 2020-3. https://kawaguchi-mmc.org/wp-content/uploads/clinicalresearch-r02.pdf .
在结直肠肿瘤切除术中，识别肿瘤位置很重要。术前内镜下印度墨水标记是一种广泛应用的方法，但墨水局部注射是一种不稳定的操作。尽管墨水通常是不可见的，但它可能会喷入腹腔并污染手术区域。在我们医院，我们引入了使用 Zeoclip FS（一种使用近红外荧光树脂开发的内镜夹）的荧光夹标记（FCM）。我们通过回顾性比较使用 FCM 的病例和使用传统墨水标记的病例来测试 FCM 的有用性。
我们招募了 2017 年 1 月至 2022 年 4 月期间因术前标记而行结直肠手术的 305 例结直肠肿瘤患者。我们将患者分为 FCM 组（86 例）和印度墨水纹身组（219 例）。FCM 组在手术前一天完成内镜标记，并用荧光腹腔镜系统在手术期间评估荧光。回顾性比较两组患者的背景、标记可见性、不良反应和术后早期结果。
FCM 组 80 例（93.02%）患者的标记在视觉上得到确认，印度墨水纹身组 166 例（75.80%）患者的标记在视觉上得到确认（p=0.0006）。在印度墨水纹身组中，有 7 例（3.20%）观察到手术野污染。FCM 组未观察到不良反应。
在结直肠手术中，FCM 比传统的印度墨水纹身方法提供更好的可视性，是一种简单、安全的标记方法。
腹腔镜结直肠癌手术荧光导航检查。川口市立医疗中心（日本埼玉县）审查委员会批准号：2020-3。https://kawaguchi-mmc.org/wp-content/uploads/clinicalresearch-r02.pdf。
