No-Touch isolation technique in colon cancer: A controlled prospective trial

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Abstract
In order to assess the effect of the no‐touch isolation technique, in the treatment of large bowel cancers, on the site of first recurrence and disease‐free and overall survival, 236 patients were prospectively and randomly assigned to either the no‐touch isolation technique (117 patients) or to a conventional resection technique (119 patients). No patient with distant metastases or unresectable disease entered the study. The two treatment groups were comparable with regard to patient characteristics. Pre‐ and postoperative complications (including mortality within 30 days) were similar in both groups. After a complete follow‐up of 5 years, a tendency for reduction in the number of, and time to, occurrences of liver metastases was seen in the no‐touch isolation group (P = 0.14). This effect was most obvious in the sigmoid colon with angio‐invasive growth. Overall (P = 0.42) and corrected (P = 0.25) survival did not differ significantly among the treatment groups although in every analysis the survival data of the no‐touch isolation group were superior. The data do suggest a limited benefit of the no‐touch isolation technique. This observation is important since the morbidity and mortality of surgery were equal in both groups.