TY - JOUR
T1 - When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement
AU - Medina-Prado, L.
AU - Hassan, C.
AU - Dekker, E.
AU - Bisschops, R.
AU - Alfieri, Sergio
AU - Bhandari, P.
AU - Bourke, M. J.
AU - Bravo, R.
AU - Bustamante-Balen, M.
AU - Dominitz, J.
AU - Ferlitsch, M.
AU - Fockens, P.
AU - van Leerdam, M.
AU - Lieberman, D.
AU - Herraiz, M.
AU - Kahi, C.
AU - Kaminski, M.
AU - Matsuda, T.
AU - Moss, A.
AU - Pellise, M.
AU - Pohl, H.
AU - Rees, C.
AU - Rex, D. K.
AU - Romero-Simo, M.
AU - Rutter, M. D.
AU - Sharma, P.
AU - Shaukat, A.
AU - Thomas-Gibson, S.
AU - Valori, R.
AU - Jover, R.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - colon cancer
KW - tatooing
KW - colon cancer
KW - tatooing
UR - http://hdl.handle.net/10807/177518
U2 - 10.1016/j.cgh.2021.01.024
DO - 10.1016/j.cgh.2021.01.024
M3 - Article
SN - 1542-3565
VL - 19
SP - 1038
EP - 1050
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
ER -