Role of preoperative endoscopic clipping in laparoscopic distal gastrectomy for early gastric cancer

Park, Dae Hwa; Moon, Hee Seok; Sul, Ji Young; Kwon, In Sun; Yun, Gee Young; Lee, Seo Hee; Park, Jae Ho; Kim, Ju Seok; Kang, Sun Hyung; Lee, Eaum Seok; Kim, Seok Hyun; Sung, Jae Kyu; Lee, Byung Seok; Kim, Jeong Il

doi:10.1097/md.0000000000013165

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…For gastric cancer surgery, in most cases, determining the gastric transection line on the oral side is important for curability and functional preservation. Intraoperative upper gastrointestinal endoscopy and X-rays are popular techniques in addition to pigments and ink in colorectal surgery (8)(9)(10)(11)(12). Furthermore, with X-ray techniques, radiation exposure is a heavy burden (8, 9), and staff must wear protective clothing.…”

Section: Endoscopic Local Injection Of Icgmentioning

confidence: 99%

“…In gastric cancer surgery, determining the gastric transection line on the oral side is especially important. Intraoperative upper gastrointestinal endoscopy or intraoperative X-rays are more popular than marking with pigments or ink in colorectal surgery (8)(9)(10)(11)(12). However, the complexity of the procedure, radiation exposure and the need for an endoscopist are major limitations.…”

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confidence: 99%

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Usefulness of Preoperative Endoscopic Fluorescent Clip Marking in Laparoscopic Gastrointestinal Surgery

et al. 2020

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Background/Aim: Precise tumor localization during gastrointestinal surgery improves curability and function preservation. We investigated the efficacy of preoperative endoscopic fluorescent clip marking using a Zeoclip FS with built-in near-infrared fluorescent resins in delineating gastrointestinal cancer for surgery. Patients and Methods: We evaluated the intraoperative visibility of the Zeoclip FS using a VISERA ELITE 2 and the short-term outcomes of 37 cancer patients (colorectal, n=23; gastric, n=14) who underwent preoperative fluorescent clip marking. Results: The study included 23 male and 14 female subjects with a mean age of 73 years (range=39-87 years). Thirty-three patients (89.1%) exhibited clear fluorescent clip marking and easily determined transection lines. Fluorescence was not observed in 1 sigmoid colon cancer patient (2.7%), who required a colonic stent for preoperative obstruction. Three patients (8.1%) required additional procedures for fluorescence visualization. Conclusion: Endoscopic fluorescent clip marking can delineate tumors well for determining the extent of resection.

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Section: Endoscopic Local Injection Of Icgmentioning

confidence: 99%

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confidence: 99%

Usefulness of Preoperative Endoscopic Fluorescent Clip Marking in Laparoscopic Gastrointestinal Surgery

et al. 2020

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“…However, under laparoscopic view, it is difficult to determine the location and safety margin of the tumor unless there is serosal involvement. To overcome this challenge, many surgeons have explored numerous methods [ 10 – 13 , 17 – 20 ]. These methods require additional preoperative or intraoperative procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Lesions in the middle to upper thirds of the stomach can also be challenging for surgeons while performing distal or total gastrectomy. Many methods for tumor localization have been reported, such as intraoperative gastroscopy, preoperative endoscopic clipping, autologous blood tattooing, and preoperative f luorescence marking [10][11][12][13]. These methods require additional procedures besides the planned surgery, which might cause discomfort to patients and increase the cost of treatment.…”

Section: Introductionmentioning

confidence: 99%

Transpyloric optic navigation of tumor using a laparoscope during totally laparoscopic distal gastrectomy for gastric cancer

Lee

Kim

Kang

et al. 2021

J Minim Invasive Surg

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Purpose: The purpose of this study was to describe the technique of intraoperative transpyloric optic navigation (TPON) and determine its efficacy and feasibility during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer.Methods: Seventy-nine patients who underwent laparoscopic gastrectomy with transpyloric optic localization of the tumor from January 2016 through December 2018 were enrolled in this study. After resecting the first portion of the duodenum, the distal part of the stomach was exteriorized through an extended supraumbilical trocar site, and a balloon trocar was introduced from the pylorus to determine the location of tumor and determine its resection margin. The clinicopathologic and surgical outcomes were analyzed. Results:The tumor was located in the lower third of the stomach in 39 cases, the middle third in 34 cases, and the upper-third in six cases. Tumor localization was successful in 67 patients. The mean proximal margin was 41.7 ± 26.8 mm. There was no morbidity related to the technique. By the fifth postoperative day, the average white blood cell count was within the normal range and the average level of C-reactive protein showed a decreasing pattern. Conclusion:TPON of the tumor during TLDG is an effective and feasible method to determine the tumor location and to obtain an adequate resection margin.

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“…Another previously reported method for localisation involves endoscopic clips. Clip placement was found to be technically feasible with no reported placement complications, and an intra‐operative localisation rate of 96%–100% 11,14,17,18 . However, current literature on the topic is limited to either case reports or small pilot studies examining the utility of clips for intra‐operative localisation, rather than for pre‐operative localisation 11,14,18,19 .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic clips allow for accurate pre‐operative localisation of colorectal cancer

Parys

Park

Entriken

et al. 2021

ANZ Journal of Surgery

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Background Colorectal cancer is a major cause of morbidity and mortality worldwide. Optimal management of this disease relies upon accurate pre‐operative localisation to allow multidisciplinary discussion and treatment planning. Current pre‐operative localisation methods consist of colonoscopy and computed tomography (CT), which are only 79%–85% accurate. To minimise this error, colonoscopy tattooing is a routine practice to facilitate operative localisation. The aim of this study is to investigate if endoscopic radiopaque clips can more accurately localise the lesions pre‐operatively. Methods A retrospective case–control study was conducted of patients diagnosed with colorectal cancer at a tertiary hospital between 2017 and 2019. Visualisation rates and accurate localisation rates were compared between patients receiving radiopaque clips and those who had colonoscopy alone. All patients received a tattoo distal to the tumour and a staging CT. Data on patient demographics, tumour demographics, post‐procedure complications and changes to surgical management were collected. Results Of 285 patients, 245 had tumour localisation with colonoscopy alone and 40 had additional clip localisation. Groups had comparable patient demographics. For patients receiving clips and follow‐up CTs within 14 days, 92% of lesions were visualised and 100% of these lesions were accurately localised. In contrast, colonoscopy only accurately localised 77% of lesions (p < 0.01). This resulted in 1.2% of patients requiring an altered operation due to incorrect localisation. No clip‐related complications were reported. Conclusion Radiopaque clips are a highly accurate and cost‐effective method for localising colorectal cancer with a pre‐operative accuracy rate over 92%.

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Role of preoperative endoscopic clipping in laparoscopic distal gastrectomy for early gastric cancer

Cited by 7 publications

References 21 publications

Usefulness of Preoperative Endoscopic Fluorescent Clip Marking in Laparoscopic Gastrointestinal Surgery

Usefulness of Preoperative Endoscopic Fluorescent Clip Marking in Laparoscopic Gastrointestinal Surgery

Transpyloric optic navigation of tumor using a laparoscope during totally laparoscopic distal gastrectomy for gastric cancer

Endoscopic clips allow for accurate pre‐operative localisation of colorectal cancer

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