When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement

Medina-Prado, Lucía; Hassan, Cesare; Dekker, Evelien; Bisschops, Raf; Alfieri, Sergio; Bhandari, Pradeep; Bourke, Michael J.; Bravo, Raquel; Bustamante-Balén, Marco; Dominitz, Jason A.; Ferlitsch, Monika; Fockens, Paul; Leerdam, Monique E. van; Lieberman, David A.; Herráiz, Maite; Kahi, Charles J.; Kamiński, Michał; Matsuda, Takahisa; Moss, Alan; Pellisé, María; Pohl, Heiko; Rees, Colin; Rex, Douglas K.; Romero-Simó, Manuel; Rutter, Matthew D.; Sharma, Prateek; Shaukat, Aasma; Thomas‐Gibson, Siwan; Valori, Roland; Jover, Rodrigo

doi:10.1016/j.cgh.2021.01.024

Cited by 13 publications

(18 citation statements)

References 24 publications

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“…Endoscopist "doubts" ability to remove a high-risk lesion 15 ; large sessile polyps removed piecemeal or not completely resected 8 ; should always be used after endoscopic resection 16 Lesion to be referred for consideration of surgical resection Before surgery. [17][18][19][20][21][22][23] "Small lesions marked before surgery" 24 Lesion to be referred for consideration of endoscopic resection Lesion that may require localization at future endoscopic procedures 22 Lesion that is difficult to visualize endoscopically "Difficult-to-detect. "…”

Section: Tattoo Indicationsmentioning

confidence: 99%

“…[17][18][19][20][21][22][23] "Small lesions marked before surgery" 24 Lesion to be referred for consideration of endoscopic resection Lesion that may require localization at future endoscopic procedures 22 Lesion that is difficult to visualize endoscopically "Difficult-to-detect. " 16,25 Resected lesions with "difficulty for later localization" 26 Lesion that endoscopist wishes to surveil Polypectomy, EMR, or ESD sites. 25 "For follow-up. "…”

Section: Tattoo Indicationsmentioning

confidence: 99%

“…22 Tattoo except "where the cecum is still visible. " 23 Photograph with cecum landmarks "adequate" 22 : "should not be used in the cecum" 16 Tattoo upper rectal lesions (mid and low rectal lesions excluded), suspected rectosigmoid lesions, and suspected rectal neuroendocrine tumors Rectum: "should not be" tattooed. 16,34 "Unnecessary. "…”

Section: Tattoo Indicationsmentioning

confidence: 99%

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Recommendations for Optimal Endoscopic Localization of Colorectal Neoplasms: A Delphi Consensus of National Experts

Vergis

Singh

Park

et al. 2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Colonoscopy is the standard of care for diagnosis and evaluation of colorectal cancers before surgery. However, varied practices and heterogenous documentation affects communication between endoscopists and operating surgeons, hampering surgical planning. OBJECTIVE: This study aimed to develop recommendations for the use of standardized localization and reporting practices for colorectal lesions identified during lower GI endoscopy. DESIGN: A systematic review of existing endoscopy guidelines and thorough narrative review of the overall endoscopy literature were performed to identify existing practices recommended globally. SETTING: An online Delphi process was used to establish consensus recommendations based on a literature review. PATIENTS: Colorectal surgeons and gastroenterologists from across Canada who had previously demonstrated leadership in endoscopy, managed large endoscopy programs, produced high-impact publications in the field of endoscopy, or participated in the development of endoscopy guidelines were selected to participate. PRIMARY OUTCOME MEASURES: The primary outcomes measured were colorectal lesion localization and documentation practice recommendations important to planning surgical or advanced endoscopic excisions. RESULTS: A total of 129 of 197 statements achieved consensus after 3 rounds of voting by 23 experts from across Canada. There was more than 90% participation in each round. Recommendations varied according to lesion location in the cecum, colon, or rectum and whether the referral was planned for surgical or advanced endoscopic resection. Recommendations were provided for appropriate documentation, indications, location, and method of tattoo placement, in addition to photograph and real-time 3-dimensional scope configuration device use. LIMITATIONS: Because of a paucity of evidence, recommendations are based primarily on expert opinion. There may be bias, as all representatives were based in Canada. CONCLUSIONS: Best practices to optimize endoscopic lesion localization and communication are not addressed in previous guidelines. This consensus involving national experts in colorectal surgery and gastroenterology provides a framework for efficient and effective colorectal lesion localization. See Video Abstract at http://links.lww.com/DCR/C71. RECOMENDACIONES PARA LA LOCALIZACIÓN ENDOSCÓPICA ÓPTIMA DE LAS NEOPLASIAS COLORRECTALES: UN CONSENSO DELPHI DE EXPERTOS NACIONALES ANTECEDENTES: La colonoscopia es el estándar de atención para el diagnóstico y la evaluación de los cánceres colorrectales antes de la cirugía. Sin embargo, las prácticas variadas y la documentación heterogénea afectan la comunicación entre los endoscopistas y los cirujanos operadores, lo que dificulta la planificación quirúrgica. OBJETIVO: Este estudio tuvo como objetivo desarrollar recomendaciones para el uso de prácticas estandarizadas de localización y notificación de lesiones colorrectales identificadas en la endoscopia gastrointestinal inferior. DISEÑO: Se realizó una revisión sistemática de las pautas de endoscopia existentes y una revisión narrativa exhaustiva de la literatura general sobre endoscopia para identificar las prácticas existentes recomendadas a nivel mundial. Se utilizó un proceso Delphi en línea para establecer recomendaciones de consenso basadas en la revisión de la literatura. PARTICIPANTES: Se seleccionaron para participar cirujanos colorrectales y gastroenterólogos de todo Canadá que previamente habían demostrado liderazgo en endoscopia, manejado grandes programas de endoscopia, producido publicaciones de alto impacto en el campo de la endoscopia o que habían participado en el desarrollo de pautas de endoscopia. RESULTADOS: Localización de lesiones colorrectales y recomendaciones prácticas de documentación importantes para planificar escisiones quirúrgicas o endoscópicas avanzadas. RESULTADOS: 129 de 197 declaraciones lograron consenso después de tres rondas de votación de 23 expertos de todo Canadá. Hubo >90% de participación en cada ronda. Las recomendaciones variaron según la ubicación de la lesión en el ciego, colon o recto, y si se planificó la derivación para resección quirúrgica o endoscópica avanzada. Se proporcionaron recomendaciones para la documentación adecuada, las indicaciones, la ubicación y el método de colocación del tatuaje, además de la fotografía y el uso del dispositivo de configuración del alcance 3D en tiempo real. LIMITACIONES: Debido a la escasez de evidencia, las recomendaciones se basan principalmente en la opinión de expertos. Puede haber sesgo, ya que los representantes tenían su sede en Canadá. CONCLUSIONES: Las mejores prácticas para optimizar la localización y comunicación de lesiones endoscópicas no se abordan en las guías anteriores. Este consenso que involucra a expertos nacionales en cirugía colorrectal y gastroenterología proporciona un marco para la localización eficiente y efectiva de lesiones colorrectales. Consulte Video Resumen en http://links.lww.com/DCR/C71. (Traducción—Dr. Mauricio Santamaria)

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Section: Tattoo Indicationsmentioning

confidence: 99%

Section: Tattoo Indicationsmentioning

confidence: 99%

Section: Tattoo Indicationsmentioning

confidence: 99%

See 1 more Smart Citation

Recommendations for Optimal Endoscopic Localization of Colorectal Neoplasms: A Delphi Consensus of National Experts

Vergis

Singh

Park

et al. 2022

Diseases of the Colon &Amp; Rectum

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“…This is because of the high risk for incomplete resection and LN metastasis. Instead, targeted biopsies from endoscopically suspicious areas should be performed, and the lesion should be marked distally with a tattoo to aid in detection at subsequent surgical resection [ 22 ]. In these situations, further evaluation for locoregional staging to detect lymph node involvement is also warranted.…”

Section: Approach To Diagnosis and Stagingmentioning

confidence: 99%

Minimally Invasive Endoscopic and Surgical Management of Rectal Neoplasia

Ghamdi

Leeds

Fang

et al. 2022

Cancers

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Rectal cancer demonstrates a characteristic natural history in which benign rectal neoplasia precedes malignancy. The worldwide burden of rectal cancer is significant, with rectal cancer accounting for one-third of colorectal cancer cases annually. The importance of early detection and successful management is essential in decreasing its clinical burden. Minimally invasive treatment of rectal neoplasia has evolved over the past several decades, which has led to reduced local recurrence rates and improved survival outcomes. The approach to diagnosis, staging, and selection of appropriate treatment modalities is a multidisciplinary effort combining interventional endoscopy, surgery, and radiology tools. This review examines the currently available minimally invasive endoscopic and surgical management options of rectal neoplasia.

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“…), categorize it as a “complex lesion” and decide if he/she can resect it. If not, the lesion should not be biopsied (unless an invasive carcinoma is suspected), and a tattoo should be placed not too close to the lesion[ 66 ]. Several pictures and videos should be taken.…”

Section: How To Set Up a Referral Endoscopy Unit For The Management O...mentioning

confidence: 99%

How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

Bustamante-Balén

2022

World J Gastroenterol

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Implementing population-based screening programs for colorectal cancer has led to an increase in the detection of large but benign histological lesions. Currently, endoscopic mucosal resection can be considered the standard technique for the removal of benign lesions of the colon due to its excellent safety profile and good clinical results. However, several studies from different geographic areas agree that many benign colon lesions are still referred for surgery. Moreover, the referral rate to surgery is not decreasing over the years, despite the theoretical improvement of endoscopic resection techniques. This article will review the leading causes for benign colorectal lesions to be referred for surgery and the influence of the endoscopist experience on the referral rate. It will also describe how to categorize a polyp as complex for resection and consider an endoscopist as an expert in endoscopic resection. And finally, we will propose a framework for the accurate and evidence-based treatment of complex benign colorectal lesions.

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When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement

Cited by 13 publications

References 24 publications

Recommendations for Optimal Endoscopic Localization of Colorectal Neoplasms: A Delphi Consensus of National Experts

Recommendations for Optimal Endoscopic Localization of Colorectal Neoplasms: A Delphi Consensus of National Experts

Minimally Invasive Endoscopic and Surgical Management of Rectal Neoplasia

How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

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