Preoperative endoscopic clipping for rectal tumor localization in laparoscopic anterior resection

Background: Increasing the number of rectal tumors undergoing preoperative chemoradiotherapy or endoscopic resection has increased the importance of accurate tumor localization. This study describes the preoperative endoscopic clipping method for the localization of rectal tumors and evaluated the feasibility of this technique. Material and methods: A total of 109 patients underwent preoperative endoscopic clipping to localize non-palpable rectal adenocarcinomas, which were located within 10?cm from the anal verge. Two endoscopic clips were attached to both lateral sides of the tumor?s distal edge. For confirming the distal margin of tumors during surgery, attempts were made to palpate the clips by digital rectal examination. Results: In all 109 cases, endoscopic clips applied to targeted rectal lesions were easily palpable in the operating room. None of the tumors showed involvement at the distal resection margins (median 1.5?cm) in histopathology. Conclusion: Preoperative endoscopic clipping methods can be useful for localizing non-palpable rectal tumors.