TY - JOUR
T1 - When and How To Use Endoscopic Tattooing in the Colon
T2 - An International Delphi Agreement
AU - Medina-Prado, Lucía
AU - Hassan, Cesare
AU - Dekker, Evelien
AU - Bisschops, Raf
AU - Alfieri, Sergio
AU - Bhandari, Pradeep
AU - Bourke, Michael J.
AU - Bravo, Raquel
AU - Bustamante-Balen, Marco
AU - Dominitz, Jason
AU - Ferlitsch, Monika
AU - Fockens, Paul
AU - van Leerdam, Monique
AU - Lieberman, David
AU - Herráiz, Maite
AU - Kahi, Charles
AU - Kaminski, Michal
AU - Matsuda, Takahisa
AU - Moss, Alan
AU - Pellisé, Maria
AU - Pohl, Heiko
AU - Rees, Colin
AU - Rex, Douglas K.
AU - Romero-Simó, Manuel
AU - Rutter, Matthew D.
AU - Sharma, Prateek
AU - Shaukat, Aasma
AU - Thomas-Gibson, Siwan
AU - Valori, Roland
AU - Jover, Rodrigo
N1 - Publisher Copyright:
© 2021 AGA Institute
PY - 2021/5
Y1 - 2021/5
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.
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U2 - 10.1016/j.cgh.2021.01.024
DO - 10.1016/j.cgh.2021.01.024
M3 - Article
C2 - 33493699
AN - SCOPUS:85103967837
SN - 1542-3565
VL - 19
SP - 1038
EP - 1050
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 5
ER -