To the Editor.—I feel compelled to respond to the letter by Frank Sparks, MD, regarding the technique of no-touch isolation for colon cancer (Archives 1980;115:1136).
Whether the avoidance of operative venous dissemination of tumor cells or a full or adequate excision of potentially involved mesenteric lymph nodes is the major issue is, of course, open to debate. At least the no-touch isolation technique covers both possibilities. One swallow does not make a summer and the quoting of one rare complication seems to be irrelevant. In fact, the technique is not difficult and does not have the high complication rate intimated.
In quoting the article by Busuttil et al,1 it is suggested that segmental resection, whatever that is, is the treatment of choice. A knowledge of the lymphatic pathway from the sigmoid colon would confirm that a left hemicolectomy for a sigmoid cancer is not necessary anyway.
JAGELMAN DG. No-Touch Isolation Technique for Colon Cancer. Arch Surg. 1981;116(2):253. doi:10.1001/archsurg.1981.01380140097033
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