When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement

Sergio Alfieri, L. Medina-Prado, C. Hassan, E. Dekker, R. Bisschops, P. Bhandari, M. J. Bourke, R. Bravo, M. Bustamante-Balen, J. Dominitz, M. Ferlitsch, P. Fockens, Leerdam M. van, D. Lieberman, M. Herraiz, C. Kahi, M. Kaminski, T. Matsuda, A. Moss, M. PelliseH. Pohl, C. Rees, D. K. Rex, M. Romero-Simo, M. D. Rutter, P. Sharma, A. Shaukat, S. Thomas-Gibson, R. Valori, R. Jover

Risultato della ricerca: Contributo in rivistaArticolo in rivista


Background & Aims: There is a lack of clinical studies to establish indications and methodology for tattooing, therefore technique and practice of tattooing is very variable. We aimed to establish a consensus on the indications and appropriate techniques for colonic tattoo through a modified Delphi process. Methods: The baseline questionnaire was classified into 3 areas: where tattooing should not be used (1 domain, 6 questions), where tattooing should be used (4 domains, 20 questions), and how to perform tattooing (1 domain 20 questions). A total of 29 experts participated in the 3 rounds of the Delphi process. Results: A total of 15 statements were approved. The statements that achieved the highest agreement were as follows: tattooing should always be used after endoscopic resection of a lesion with suspicion of submucosal invasion (agreement score, 4.59; degree of consensus, 97%). For a colorectal lesion that is left in situ but considered suitable for endoscopic resection, tattooing may be used if the lesion is considered difficult to detect at a subsequent endoscopy (agreement score, 4.62; degree of consensus, 100%). A tattoo should never be injected directly into or underneath a lesion that might be removed endoscopically at a later point in time (agreement score, 4.79; degree of consensus, 97%). Details of the tattoo injection should be stated clearly in the endoscopy report (agreement score, 4.76; degree of consensus, 100%). Conclusions: This expert consensus has developed different statements about where tattooing should not be used, when it should be used, and how that should be done.
Lingua originaleEnglish
pagine (da-a)1038-1050
Numero di pagine13
RivistaClinical Gastroenterology and Hepatology
Stato di pubblicazionePubblicato - 2021


  • colon cancer
  • tatooing


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