Document Detail

The effect of colonoscopic tattooing on lymph node retrieval and sentinel lymph node mapping.
MedLine Citation:
PMID:  22835497     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In colorectal cancer (CRC), colonoscopic tattooing is performed to mark the tumor site before laparoscopic surgery.
OBJECTIVE: To determine whether colonoscopic tattooing can be used to refine staging accuracy by increasing the lymph node (LN) yield per specimen and to determine its accuracy as a sentinel LN procedure.
DESIGN: Retrospective, case-control study. All LNs were microscopically examined for the presence of carbon particles.
SETTING: A university hospital and a teaching hospital.
PATIENTS: A consecutive series of 95 tattooed patients who had surgery for CRC between 2005 and 2009. A series of 210 non-tattooed patients who had surgery in the same time period served as controls.
MAIN OUTCOME MEASUREMENTS: Total number of LNs retrieved, detection rate, and sensitivity of tattooing as a sentinel node procedure.
RESULTS: A higher LN yield was observed in patients with preoperative tattooing, median (interquartile range) 15 (10-20) versus 12 (9-16), (P = .014). In multivariable analysis, the presence of carbon-containing LNs was an independent predictive factor for a higher LN yield (P = .002). The detection rate was 71%, with a median of 5 carbon-containing LNs per specimen. If preoperative tattooing was used for sentinel node mapping, the overall accuracy of predicting LN status was 94%. In the 24 N1 cases, there were 4 false-negative procedures (sensitivity 83%).
LIMITATIONS: Retrospective series.
CONCLUSION: After tattooing of CRC, the LN yield was higher than in a control group, and it could be used as a sentinel node procedure with acceptable accuracy rates. Because LN yield and sentinel node mapping are associated with improved diagnostic accuracy of LN involvement, preoperative tattooing can refine staging.
Sanne A L Bartels; Edwin S van der Zaag; Evelien Dekker; Christianne J Buskens; Willem A Bemelman
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2012-07-25
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  76     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-18     Completed Date:  2013-02-19     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  793-800     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.
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MeSH Terms
Colectomy / methods
Colonoscopy / methods*
Colorectal Neoplasms / pathology,  surgery*
False Negative Reactions
Lymph Node Excision / statistics & numerical data*
Middle Aged
Multivariate Analysis
Neoplasm Staging
Preoperative Care / methods*
Rectum / surgery
Retrospective Studies
Sensitivity and Specificity
Sentinel Lymph Node Biopsy
Comment In:
Gastrointest Endosc. 2013 May;77(5):831-2   [PMID:  23582537 ]
Gastrointest Endosc. 2013 May;77(5):831   [PMID:  23582536 ]
Gastrointest Endosc. 2012 Oct;76(4):801-3   [PMID:  22985644 ]

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