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March 17, 1975

The No-Touch Isolation Technique of Resection

Author Affiliations

From the Department of Colon and Rectal Surgery, the Cleveland Clinic Foundation, Cleveland.

JAMA. 1975;231(11):1181-1182. doi:10.1001/jama.1975.03240230053026

FISHER and I,1 in 1955, reported finding cancer cells in the blood of the mesenteric veins that were draining tumors of the colon in eight of 25 patients who were undergoing resection. Subsequently, we studied the portal venous blood of 67 patients undergoing resection for colorectal cancer; we found that malignant cells were found more frequently in the blood of those whose cancer had been manipulated during resection. We recognized that carcinomas of the gastrointestinal tract invade the portal venous radicals and shed cells and that these cells embolize to the liver, where they grow as fatal metastases. Fisher and Fisher2 not only demonstrated these cells, but also showed experimentally that the liver metastases were more likely to occur when a certain dose of tumor cells was exceeded.

Because of our findings, those of Fisher and Fisher,2 and Cole et al,3 in 1953, we utilized a