Routine or Selective Endoscopic Tattooing in Colon Resection for Cancer

Abstract

I have read with interest the article by Briceñ o and coworkers 1 published in the May 2010 issue of Archives. It is a well-designed study about the usefulness of a carrier-bound fibrin sealant to treat the raw surface of the liver after resection.One of the secondary outcome measures was postoperative drainage output volume. In their Figure 1, Briceñ o et al 1 present a flowchart in which it can be seen that 25 patients received a major hepatectomy with application of a carrier-bound collagen sponge on the raw surface of the liver. They also wrote that, in the collagen sponge group, 1 or 2 sponges were applied relative to the cut surface.I have used this fibrin sealant, and I agree with the result of a reduction in postoperative drainage output volume. This effect is well recognized by an experimental study. 2 To facilitate the reduction in drainage output volume, a "new Glisson surface" on the resected liver should be made by a fibrinsealant.Therefore,alloftheliversurfaceshouldbesealed starting 1 to 2 cm above the Glisson surface of the cut surface. In this way, 1 or 2 fibrin sealant sponges are not sufficient to cover all of the liver surface in case of a major hepatectomy, leaving free parts of resected liver surface. ). Financial Disclosure: None reported. 1. Briceñ o J, Naranjo A, Ciria R, et al. A prospective study of the efficacy of clinical application of a new carrier-bound fibrin sealant after liver resection. Arch Surg. 2010;145(5):482-488. 2. Erdogan D, de Graaf W, van Gulik TM. Adhesive strength of fibrinogencoated collagen patch or liquid fibrin sealant in an experimental liver resection model in pigs.