title: Colonic tumour localization using an endoscope positioning device.
abstract: OBJECTIVE
  Although colonoscopy is reliable in identifying colorectal cancer (CRC), studies have demonstrated incorrect tumour localization in 21-34% of colonoscopies when compared with surgical localization. The aim of this study was to determine our accuracy in determining the position of CRCs detected at colonoscopy with the aid of the ScopeGuide endoscope positioning device.
  
  
  METHODS
  Cancers identified within the English National Bowel Cancer Screening Programme were studied. Retrospective analysis was undertaken of all patients diagnosed with CRC during the first screening round in Wolverhampton Bowel Cancer Screening Centre, England. ScopeGuide was used in all cases. Data from colonoscopy reports, computed tomography reports and surgical resection specimens were analysed.
  
  
  RESULTS
  A total of 82 cancers were identified within the surgical resection specimen in 80 patients. Two proximal cancers were not identified at colonoscopy due to obstruction by the distal cancers. Colonoscopy with the aid of the endoscopy positioning device correctly identified the tumour location in 93.75% of cases in which the tumour could be reached endoscopically. Abdominopelvic computed tomography localized 82.5% of CRC.
  
  
  CONCLUSIONS
  The ScopeGuide endoscopy positioning device enables accurate localization of cancers at colonoscopy. Tattooing of suspected cancer remains to be a best practice for localization during laparoscopic resection. The use of the endoscopic-positioning device may, however, result in greater confidence for localization of polypectomy sites, which have not been tattooed, in cases when cancer was not suspected but found histologically.
authors.affiliation: Department of Gastroenterology,Ward M2, Brown Building, Mater Dei Hospital, Malta. pierre_ellul@yahoo.co.uk
authors.forename: Pierre
authors.initials: P
authors.lastname: Ellul
authors.forename: Edward
authors.initials: E
authors.lastname: Fogden
authors.forename: Clare
authors.initials: C
authors.lastname: Simpson
authors.forename: Anton
authors.initials: A
authors.lastname: Buhagiar
authors.forename: Brian
authors.initials: B
authors.lastname: McKaig
authors.forename: Edwin
authors.initials: E
authors.lastname: Swarbrick
authors.forename: Andrew
authors.initials: A
authors.lastname: Veitch
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D023881:Colonography, Computed Tomographic; D020685:Colonoscopes; D003113:Colonoscopy / Q000295:instrumentation*; D004739:England; D004867:Equipment Design; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies