Clinical ScienceColonoscopic localization accuracy for colorectal resections in the laparoscopic era

- We looked at colonoscopic localization accuracy rates and its contributing factors.
- Incorrect localization was associated with incomplete colonoscopy.
- Computerized tomography and tattoo aided localization but was not always sufficient.
- Clear, effective communication is needed to minimize incorrect localization.
- Emphasis is needed to make localization a priority in colonoscopy.

BackgroundColonic 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.MethodsRetrospective review of patients who underwent colonic resection after colonoscopy between 2008 and 2013 at a single institution, with subsequent univariate and multivariate analysis.ResultsOf 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.ConclusionsColonoscopy 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.