CEA Study on the Effect of the No-touch Isolation Technique for Preventing Tumor Metastasis in Patients with Colorectal Cancer

ABSTRACT

PURPOSE: Although the 'No-touch' isolation technique was introduced by Turnbull et al. in 1967, the controversy over whether or not it reduces the risk of metastasis during surgery exists even today. The aim of this study was to evaluate the effect of the 'No-touch' isolation technique in primary colorectal cancer surgery. METHODS: The evaluation was done by comparing the levels of CEA and CEA m-RNA expression from the same draining vein before and after tumor mobilization. Blood samples from 25 patients with primary colorectal cancer were collected for analysis. At the time of surgery, the main draining vein from the tumor was isolated and ligated at the proximal end. The 1st blood samples were collected just prior to tumor mobilization, and the 2nd samples right after. Both samples were analyzed for serum CEA level and CEA mRNA expression by using reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: The mean CEA value from draining veins after tumor mobilization (8.08+/-8.98 ng/ml) was significantly higher than it was before mobilization (4.17+/-4.98 ng/ml). CEA mRNA was detected in 16% (4/25) of the blood specimens post-mobilization, whereas it was detected in only 4% (1/25) of the pre-mobilization samples. CONCLUSIONS: The results suggest the validity of using the 'No-touch' isolation technique to reduce the risk of metastasis into the draining vein during mobilization.