title: The Effects of Preoperative Endoscopic Tattooing on Distal Surgical Margin and Ileostomy Rates in Laparoscopic Rectal Cancer Surgery: A Prospective Randomized Study.
abstract: OBJECTIVE
  This study aimed to evaluate the effect of endoscopic marking on the distal surgical margin and ileostomy rates in laparoscopic rectal cancer surgery.
  
  
  METHODS
  Forty patients, who underwent surgery between September 2012 and December 2013 for rectal cancer limited to or with invasion of the upper rectum, were included in the study. The distal tumor margin was marked with purified carbon particles by colonoscopy before surgery in one group (n=20); no marking was performed in the second group (n=20). Patients were assigned randomly to each group. Laparoscopic anterior or low-anterior resection was performed in all patients. Demographic and operative data, pathology results, morbidity, and ileostomy rates were measured.
  
  
  RESULTS
  There was no statistically significant difference in the demographic data, the tumor size, the amount of bleeding, the specimen length, the harvested lymph node number, postoperative complications, the length of hospital stay, rehospitalization, and the operation duration between groups 1 and 2, respectively. The distal surgical margin was significantly shorter in the marked group. The protective ileostomy rates were also lower in the marked group; however, the difference did not reach statistical significance.
  
  
  CONCLUSIONS
  Preoperative endoscopic tattooing decreases distal resection margins and may reduce protective ileostomy rates in laparoscopic rectal surgery.
authors.affiliation: *Department of General Surgery, Faculty of Medicine, Fatih University †Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Cipe
authors.forename: Merve B
authors.initials: MB
authors.lastname: Cengiz
authors.forename: Ufuk O
authors.initials: UO
authors.lastname: Idiz
authors.forename: Erkan
authors.initials: E
authors.lastname: Yardimci
authors.forename: Umit
authors.initials: U
authors.lastname: Malya
authors.forename: Deniz
authors.initials: D
authors.lastname: Firat
authors.forename: Mahmut
authors.initials: M
authors.lastname: Muslumanoglu
mesh_terms: D005260:Female; D006801:Humans; D007081:Ileostomy / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D011351:Proctoscopy / Q000379:methods; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D017792:Surgical Stapling; D013653:Tattooing / Q000379:methods*; D016896:Treatment Outcome