Intraoperative fluoroscopy vs. intraoperative laparoscopic ultrasonography for early colorectal cancer localization in laparoscopic surgery

Abstract

Both intraoperative fluoroscopy and intraoperative laparoscopic ultrasonography are safe and accurate techniques for intraoperative localization of early CRC. With regard to detection time, intraoperative laparoscopic ultrasonography is superior to intraoperative fluoroscopy. However, when there is a massive amount of intestinal air, intraoperative laparoscopic ultrasonography is cumbersome in localizing the lesion. Computed tomography colonography is useful for preoperative tumor localization and might be effective for shortening detection time during surgery.

Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy

“…Unfortunately, laparoscopic ultrasonography is strongly operator dependent, and the equipment is not widely available. Intraoperative fluoroscopy may also be an effective localization method [9]. However, it requires C-arm fluoroscopy and carries the risks of greater radiation hazards not only to the patient but also to surgeons.…”

“…Previously, several tumor localization methods have been introduced, including endoscopic tattooing, intraoperative endoscopy, intraoperative laparoscopic ultrasonography, and intraoperative fluoroscopy [5][6][7][8][9]. Although these methods provide good results, usually they are time consuming or require special equipment.…”

Intraoperative hydrocolonic ultrasonography for localization of small colorectal tumors in laparoscopic surgery

“…Montorsi et al [15] proposed using metallic clips preoperatively to mark the tumor's location, thus allowing an acoustic shadow of the clip. Although, this is an elegant solution, it does not solve the problem of gas in the bowel that may hide the clips, which in fact did occur in some cases during a recent study [16]. Furthermore, it requires two colonoscopies, one for diagnostic purposes and another for applying the clips, and there is the possibility of clip dislodgment.…”

Minimum-invasive early diagnosis of colorectal cancer with CT colonography: techniques and clinical value

“…Precise localization for early stage CRC is required, not only for laparoscopic surgery but also for open surgery, because these tumors cannot be palpated manually in many cases owing to shallow tumor invasion, small size and a lack of visible serosal signs [111,112] . Furthermore, laparoscopic surgery has heightened the importance of preoperative localization because laparoscopic approaches, including factors such as port positions, incision site and size, are based on tumor location and dimensions.…”