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Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. 10 Since the life expectancy of the polyp-age group may be as long as 20 to 30 years, this raises the question of the long-term safety of India ink tattoos in the However, when the tattoo is used as a guide for follow-up colonoscopic examinations after a large sessile polypectomy, the tattoo probably remains in the colon for the remainder of that patient's life. When an endoscopic tattoo is used to guide the surgeon to a lesion that is to be resected, the tattoo is removed with the lesion. Biopsies in 6 patients showed mild chronic inflammation in the lamina propria and 1 showed mild DISCUSSION In 48 patients, the biopsies were interpreted as histologically normal (Fig.
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There were no clinical symptoms or infectious complications in any of the 55 patients. There were no endoscopic abnormalities on or adjacent to the tattoos.
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Tattoos did not disappear in any of the patients who had more than one colonoscopy. The RESULTSĪll tattoos were easily identifiable, including the one present for 117 months. Seventeen patients were followed-up over a period of time, with two biopsies in 16 and three biopsies in 1. Biopsy specimens were obtained from each tattoo mark encountered and were fixed in formalin and stained with hemotoxylin-eosin. There were 55 patients with 56 tattoo sites (39 men, 16 women age range 38 to 89 years old). The clinical status and endoscopic and histologic appearance were evaluated in 55 patients during postpolypectomy surveillence colonoscopies from 1993 to 1995. Conclusions: Small-volume India ink tattooing of the colon appears to remain endoscopically identifiable over a long term and to be safe based on histologic analysis of sequential biopsies. There were no neoplastic changes of the mucosa overlying the tattoo. There were no histologic changes seen at the tattoo sites in 48 patients, mild chronic inflammation in 6 patients, and hyperplastic change in 1 patient. Results: There were no clinical complications such as infection, fever, or abdominal pain in any of the 55 patients. A total of 74 biopsy specimens were obtained from tattoos that had been placed an average of 36 months prior to biopsy (range 1.5 to 117 months). Seventeen of these patients were followed serially with two biopsies in 16 patients and three biopsies in 1 patient. Methods: Biopsy specimens were taken from all tattoo marks encountered during postpolypectomy surveillence colonoscopy in 55 patients. The long-term clinical and histologic consequences of the tattoo have not been studied in a large group of patients. This raises the question of the long-term safety of India ink tattoos. Background: When the India ink tattoo is used as a guide for follow-up examinations, the tattoo may remain in the colon for the remainder of that patient's life.