BACKGROUND Neoadjuvant therapy can reduce the size of gastroesophageal tumors to the extent that they are no longer macroscopically visible.This may increase the risk of microscopic-positive resection margins.One pote...BACKGROUND Neoadjuvant therapy can reduce the size of gastroesophageal tumors to the extent that they are no longer macroscopically visible.This may increase the risk of microscopic-positive resection margins.One potential method to reduce this uncertainty could be the preoperative endoscopic marking of proximal tumor margins with BioXmark®,a novel liquid fiducial marker.This study aimed to report the initial experiences of the first ten patients marked with BioXmark®.AIM To evaluate the visibility of BioXmark®on ultrasound after preoperative marking of the proximal resection line of an esophageal tumor.METHODS The circumference of the esophagus was endoscopically marked preoperatively with a fiducial marker in four quadrants,5 cm proximal to the tumor.During the surgery,the surgeon’s proposed proximal resection line was marked.Next,an ultrasound probe was used to identify the previously placed fiducial markers,and its placement was marked.The difference between the surgeon’s proposed resection line and the fiducial marker was measured intraoperatively and subsequently examined with respect to the resection margin and status.RESULTS BioXmark®was implanted in ten patients,5 cm proximal to the tumor.The surgeon’s proposed resection line was positioned 2-6 cm proximally to the surgical marker line.Technical success of injecting the fiducial marker was achieved in all ten patients.In six patients,the marker was successfully identified intraoperatively on ultrasound.No peri-or postoperative adverse events related to BioXmark®implantation were found.CONCLUSION Excellent technical success with the implantation of the fiducial surgical marker was achieved,but limited intraoperative visibility on ultrasound was achieved.Further studies are required to optimize its clinical application.展开更多
基金Supported by Nanovi A/S provided twenty vials of BioXmark®along with financial support for the evaluation of the implementation of the fiducial marker.
文摘BACKGROUND Neoadjuvant therapy can reduce the size of gastroesophageal tumors to the extent that they are no longer macroscopically visible.This may increase the risk of microscopic-positive resection margins.One potential method to reduce this uncertainty could be the preoperative endoscopic marking of proximal tumor margins with BioXmark®,a novel liquid fiducial marker.This study aimed to report the initial experiences of the first ten patients marked with BioXmark®.AIM To evaluate the visibility of BioXmark®on ultrasound after preoperative marking of the proximal resection line of an esophageal tumor.METHODS The circumference of the esophagus was endoscopically marked preoperatively with a fiducial marker in four quadrants,5 cm proximal to the tumor.During the surgery,the surgeon’s proposed proximal resection line was marked.Next,an ultrasound probe was used to identify the previously placed fiducial markers,and its placement was marked.The difference between the surgeon’s proposed resection line and the fiducial marker was measured intraoperatively and subsequently examined with respect to the resection margin and status.RESULTS BioXmark®was implanted in ten patients,5 cm proximal to the tumor.The surgeon’s proposed resection line was positioned 2-6 cm proximally to the surgical marker line.Technical success of injecting the fiducial marker was achieved in all ten patients.In six patients,the marker was successfully identified intraoperatively on ultrasound.No peri-or postoperative adverse events related to BioXmark®implantation were found.CONCLUSION Excellent technical success with the implantation of the fiducial surgical marker was achieved,but limited intraoperative visibility on ultrasound was achieved.Further studies are required to optimize its clinical application.
