Small-dose India ink tattooing for preoperative localization of colorectal tumor.
BACKGROUND
India ink tattooing is widely used for tumor localization; however, the tattooing procedure is not yet standardized. This study aims to evaluate the efficacy of small-dose tattooing with sterile India ink using a saline test-injection method.


METHODS
Between April 2009 and August 2009, 20 patients underwent colonoscopic tattooing with prepackaged sterile India ink before resection of colorectal tumor. We injected 0.5 cc of India ink at three circumferential sites at the distal tumor using a saline test-injection method. Observation and leakage of India ink were evaluated during laparoscopic surgery, and the diameter of tattooing in the specimen was assessed.


RESULTS
Tattoos were observed intraoperatively in 18 patients (90%). In 2 patients, tattoos were not observed on the serosal surface but were detected on the mucosal surface. Localized leakage of ink was identified during surgery in 1 patient (5%), without fever or abdominal pain. Mean tattoo diameter was 2.1 cm on the serosal surface and 2.0 cm on the mucosal surface.


CONCLUSIONS
Small-dose tattooing with sterile India ink using a saline test-injection method is effective for tumor localization.
Hwang
Mi Ri
MR
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Sohn
Dae Kyung
DK
Park
Ji Won
JW
Kim
Byung Chang
BC
Hong
Chang Won
CW
Han
Kyung Su
KS
Chang
Hee Jin
HJ
Oh
Jae Hwan
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013653:Tattooing / Q000379:methods*; D016896:Treatment Outcome
D004396:Coloring Agents; C028433:chinese ink; D002244:Carbon