title: Colonoscopic localization accuracy for colorectal resections in the laparoscopic era.
abstract: BACKGROUND
  Colonic resection is increasingly performed laparoscopically, where intraoperative tumor localization is difficult. Incorrect localization can have adverse surgical results. This has not been studied in laparoscopic resection. This study aimed to evaluate colonoscopic localization accuracy, contributing factors, and subsequent surgery.
  
  
  METHODS
  Retrospective review of patients who underwent colonic resection after colonoscopy between 2008 and 2013 at a single institution, with subsequent univariate and multivariate analysis.
  
  
  RESULTS
  Of 221 lesions identified, 79.0% were correctly localized. Nine (4.0%) incorrectly localized cases required changes in surgery. Two factors were significant on multivariate analysis: gastroenterology training and incomplete colonoscopy were associated with incorrect localization.
  
  
  CONCLUSIONS
  Colonoscopy is reasonably accurate at localizing lesions. Methods such as tattooing should be used, but error is still possible. Communication between endoscopists and surgeons is vital to minimize the risk of incorrect localization. Emphasis is needed during colonoscopic training of awareness and protocolization of colonoscopic position and methods to improve localization.
authors.affiliation: Department of Surgery, Austin Health, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: raymond.yap@health.nsw.gov.au.
authors.forename: Raymond
authors.initials: R
authors.lastname: Yap
authors.affiliation: Department of Surgery, Austin Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Damian
authors.initials: D
authors.lastname: Ianno
authors.affiliation: Department of Surgery, Austin Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Adele
authors.initials: A
authors.lastname: Burgess
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013653:Tattooing
keywords: Colonoscopy; Colorectal cancer; Localization; Quality assurance