Nizam R, Siddiqi N, Landas S K, Kaplan D S, Holtzapple P G
Division of Gastroenterology, S.U.N.Y. Health Science Center, Syracuse, USA.
Am J Gastroenterol. 1996 Sep;91(9):1804-8.
To provide comprehensive information on key issues concerning colonic tattooing with India ink in reported literature.
A total of 735 citations on India ink alone were present in the English literature (1966-1995), including 16 on India ink and colonic tattooing. Nine major studies were identified and reviewed for 1) preparation before tattooing (type of ink used, sterilization process, colonic preparation, and antibiotic prophylaxis), 2) the tattooing process (technique and volume injected), 3) success in localization, and 4) complications.
A'total of 447 cases of colonic tattooing with India ink have been reported. Major indication was preoperative marking of tumor site. Various India ink preparations were used. Ink was unsterilized in 57% (255/447), autoclaved in 42% (187/447), and gas sterilized in 1% (5/447) of cases. Colonic preparation varied similarly. Prophylactic antibiotics were used in 1% (5/447) of cases. Dilution of India ink varied from undiluted to 1:100 (with 0.9% saline). The volume injected ranged from 0.1 to 2 ml per site injected, commonly with tangential needle insertion and delivery of ink into the submucosa in the majority of the cases. Intraoperative localization was easier with multiple tattoo injections. Five reports of complications have been made. In only one instance did overt clinical complications develop. Risk of a clinical complication with colonic tattooing with India ink is 0.22%.
Marked variability in technique, as well as potential for reporting bias, limit the quantitative conclusions. In general, colonic tattooing with India ink is a safe, accurate, and inexpensive method for preoperative marking and prospective study of colonic lesions.
提供文献报道中有关印度墨水结肠纹身关键问题的全面信息。
英文文献（1966 - 1995年）中仅关于印度墨水的引用共有735条，其中16条涉及印度墨水与结肠纹身。确定并回顾了9项主要研究，内容包括：1）纹身前准备（所用墨水类型、灭菌过程、结肠准备和抗生素预防）；2）纹身过程（技术和注射量）；3）定位成功率；4）并发症。
共报道了447例用印度墨水进行结肠纹身的病例。主要适应症是术前标记肿瘤部位。使用了各种印度墨水制剂。57%（255/447）的病例中墨水未灭菌，42%（187/447）的病例中墨水经高压灭菌，1%（5/447）的病例中墨水经气体灭菌。结肠准备情况也类似。1%（5/447）的病例使用了预防性抗生素。印度墨水的稀释度从未稀释到1:100（用0.9%生理盐水）不等。每个注射部位的注射量为0.1至2毫升，大多数情况下通常采用切线进针并将墨水注入黏膜下层。多次纹身注射使术中定位更容易。已有5篇关于并发症的报道。仅1例出现明显临床并发症。用印度墨水进行结肠纹身出现临床并发症的风险为0.22%。
技术上存在显著差异以及可能存在报告偏倚，限制了定量结论。总体而言，用印度墨水进行结肠纹身是一种安全、准确且廉价的术前标记和结肠病变前瞻性研究方法。
