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

Authors
 Hyoung-Il Kim  ;  Woo Jin Hyung  ;  Cho Rok Lee  ;  Joon Seok Lim  ;  Ji Yeong An  ;  Jae-Ho Cheong  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.25(3) : 958-963, 2011 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2011
MeSH
Adult ; Aged ; Carbon Dioxide ; Female ; Gastrectomy/methods* ; Gastroenterostomy ; Humans ; Laparoscopy/methods* ; Male ; Middle Aged ; Patient Selection ; Preoperative Care ; Radiography, Interventional/instrumentation* ; Retrospective Studies ; Robotics ; Stomach Neoplasms/diagnostic imaging* ; Surgical Instruments
Keywords
Stomach neoplasms Laparoscopy Abdominal radiograph Gastrectomy Endoscopy
Abstract
BACKGROUND: During laparoscopic gastrectomy, it is impossible to identify early gastric cancer (EGC) lesions; therefore, a precise localization technique is required. In this study, we evaluated a novel method of intraoperative portable abdominal radiograph for localization of EGC lesions after preoperative endoscopic clipping.

METHODS: A retrospective study of 80 patients who had undergone laparoscopic gastrectomies with our intraoperative abdominal radiographic method of tumor localization was performed. During preoperative endoscopy, endoscopic metal clips were applied just proximal to the tumor. A plain abdominal radiograph taken immediately after oral administration of effervescent agents was employed to select candidates for intraoperative localization. Intraoperative vessel clips were laparoscopically applied along the greater and lesser curvatures, and a portable abdominal radiograph was taken to identify the location of endoscopic clips relative to laparoscopic vessel clips.

RESULTS: In all patients, endoscopic clips were applied proximal to the lesion without complications. Both intraluminally and extraluminally placed clips were successfully detected by intraoperative portable abdominal radiograph in all patients. Mean ± standard deviation (SD) proximal margin length was 34.2 ± 20.2 mm. All patients had tumor-free resection margin.

CONCLUSIONS: Preoperative endoscopic clipping and intraoperative portable abdominal radiograph is an accurate and simple tumor localization method in laparoscopic gastrectomy.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-010-1288-3
DOI
10.1007/s00464-010-1288-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92610
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