Wiggers T, Jeekel J, Arends J W, Brinkhorst A P, Kluck H M, Luyk C I, Munting J D, Povel J A, Rutten A P, Volovics A
Department of Surgery, University Hospital Maastricht, The Netherlands.
Br J Surg. 1988 May;75(5):409-15. doi: 10.1002/bjs.1800750505.
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.
为评估免接触隔离技术在治疗大肠癌时对首次复发部位、无病生存期和总生存期的影响，236例患者被前瞻性随机分为免接触隔离技术组（117例患者）和传统切除技术组（119例患者）。无远处转移或不可切除疾病的患者进入本研究。两组患者的特征具有可比性。两组术前和术后并发症（包括30天内死亡率）相似。在进行了5年的完整随访后，免接触隔离组出现肝转移的数量和时间有减少的趋势（P = 0.14）。这种效果在具有血管浸润性生长的乙状结肠中最为明显。尽管在每次分析中免接触隔离组的生存数据都更优，但治疗组之间的总体生存率（P = 0.42）和校正生存率（P = 0.25）并无显著差异。数据确实表明免接触隔离技术的益处有限。这一观察结果很重要，因为两组手术的发病率和死亡率相同。
