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The effect of colonoscopic tattooing on lymph node retrieval and sentinel lymph node mapping
Sanne A L Bartels1, Edwin S van der Zaag, Evelien Dekker
1Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.
Gastrointestinal Endoscopy
|July 28, 2012
Summary
Colonoscopic tattooing in colorectal cancer (CRC) surgery increases lymph node (LN) yield and accuracy. This technique refines cancer staging by improving the detection of cancerous lymph nodes.
Area of Science:
- Oncology
- Surgical Pathology
- Medical Imaging
Background:
- Colonoscopic tattooing marks tumor sites in colorectal cancer (CRC) before laparoscopic surgery.
- Accurate lymph node (LN) staging is critical for CRC treatment and prognosis.
Purpose of the Study:
- To evaluate if colonoscopic tattooing enhances lymph node yield for improved staging accuracy.
- To assess the accuracy of colonoscopic tattooing as a sentinel lymph node (SLN) procedure.
Main Methods:
- Retrospective case-control study comparing 95 tattooed CRC patients with 210 non-tattooed controls.
- Microscopic examination of all retrieved lymph nodes for carbon particles.
- Analysis of lymph node yield, detection rates, and sentinel node procedure accuracy.
Main Results:
- Tattooed patients had a significantly higher lymph node yield (median 15 vs. 12).
- Carbon-containing lymph nodes independently predicted higher lymph node yield (P=.002).
- The tattooing procedure achieved 71% detection rate and 94% overall accuracy for predicting lymph node status.
Conclusions:
- Colonoscopic tattooing increases lymph node yield compared to controls.
- It serves as a sentinel node procedure with acceptable accuracy, improving diagnostic precision.
- Preoperative tattooing can refine colorectal cancer staging by enhancing lymph node assessment.
