Tan L, et al. – Whether or not the preoperative endoscopic placement of titanium clips could facilitate intraoperative localization of early–stage esophageal cancer or severe dysplasia, was examined in this study. Data highlighted the potential of preoperative endoscopic titanium clip placement in facilitating intraoperative localization of early–stage esophageal cancer or severe dysplasia.

Methods

• Between May 2012 and July 2014, a prospective randomized clinical trial was performed.
• In order to confirm early stage esophageal cancer or severe dysplasia, all enrolled patients received preoperative endoscopy and esophageal endoscopic ultrasound, as well as pathological study on the biopsy specimen.
• The preoperative endoscopic titanium labeling of esophageal lesions was administered in patients in the experimental group, one day before the surgical operation.
• Palpitation of titanium clips was used to localize the lesions in these patients, during the surgical operation.
• Together with the consideration of the results from preoperative endoscopic and ultrasound studies, palpitation of nodules or esophageal wall mucosal thickening, was applied in patients in the control group, to estimate the location of the esophageal lesions.
• The proportions of patients having successful intraoperative pre-resection lesion localization, post-esophagectomy lesion visualization, negative upper surgical margin, change of surgical approaches, and positive postoperative pathological diagnosis were involved in the study outcomes.

Results

• 14 in the experimental group and 13 in the control group, a total of 27 patients were enrolled into the study.
• A higher proportion of patients in the experimental group had statistically significant successful intraoperative esophageal lesion localization (100 versus 15.3% in the experimental versus control group) than the patients in the control group.