Antoine Bouvier1, Louis Besnier1, A Paisant1, Thomas Briot2, Thomas Hebert3, Valérie Daniel2, Laurent Beydon4, Merzouka Zidane Marinnes5, Nathalie Baize6, Christophe Aubé1, Pierre Bigot7. 1. Department of Radiology, Angers University Hospital, Angers, France. 2. Department of Pharmacology, Angers University Hospital, Angers, France. 3. Department of Radiology, Brest University Hospital, Brest, France. 4. Department of Anesthesiology and Reanimation, Angers University Hospital, Angers, France. 5. Department of Pathology, Angers University Hospital, Angers, France. 6. Unité transversale de thérapeutiques innovantes en oncologie médicale (UTTIOM), Angers University Hospital, Angers, France. 7. Department of Urology, Angers University Hospital, Angers, France.
Abstract
Purpose: To improve the tumor localization during laparoscopic surgery, we describe an innovative technique involving superselective intra-arterial injection of blue dye in tumoral vessels to color the tumor before surgical enucleation. Materials and Methods: The dye injection was performed at the same time as superselective embolization, immediately before laparoscopic surgery in a hybrid operating room. We used this new treatment sequence on 50 consecutive patients. Results: The selective intra-arterial injection of an emulsion of blue dye and lipiodol was feasible in 46 (92%) cases and well tolerated, followed by superselective embolization of the tumor vessels with glue or coils. The tumor was easily localized during surgery due to the blue coloration. Tumor coloration was not associated with postoperative complication, especially allergic reaction or renal failure. Pathologic analysis of the tumor was not modified by the coloration and all tumors had negative surgical margins. Conclusions: The preoperative dye localization is a feasible, safe, and accurate procedure. This combined approach reduces the difficulty of surgery and increases patient safety.
Purpose: To improve the tumor localization during laparoscopic surgery, we describe an innovative technique involving superselective intra-arterial injection of blue dye in tumoral vessels to color the tumor before surgical enucleation. Materials and Methods: The dye injection was performed at the same time as superselective embolization, immediately before laparoscopic surgery in a hybrid operating room. We used this new treatment sequence on 50 consecutive patients. Results: The selective intra-arterial injection of an emulsion of blue dye and lipiodol was feasible in 46 (92%) cases and well tolerated, followed by superselective embolization of the tumor vessels with glue or coils. The tumor was easily localized during surgery due to the blue coloration. Tumor coloration was not associated with postoperative complication, especially allergic reaction or renal failure. Pathologic analysis of the tumor was not modified by the coloration and all tumors had negative surgical margins. Conclusions: The preoperative dye localization is a feasible, safe, and accurate procedure. This combined approach reduces the difficulty of surgery and increases patient safety.