title: Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy.
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.
authors: Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, 120-752, Korea.
authors: Hyoung-Il
authors: HI
authors: Kim
authors: Woo Jin
authors: WJ
authors: Hyung
authors: Cho Rok
authors: CR
authors: Lee
authors: Joon Seok
authors: JS
authors: Lim
authors: Ji Yeong
authors: JY
authors: An
authors: Jae-Ho
authors: JH
authors: Cheong
authors: Seung Ho
authors: SH
authors: Choi
authors: Sung Hoon
authors: SH
authors: Noh
mesh_terms: D000328:Adult; D000368:Aged; D002245:Carbon Dioxide; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care; D015641:Radiography, Interventional / Q000295:instrumentation*; D012189:Retrospective Studies; D012371:Robotics; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*; D013525:Surgical Instruments
chemical_list: D002245:Carbon Dioxide