Single-Incision Laparoscopic Colectomy: A Case Match Study for Stage IV Colon Cancer

Utilization of single-incision laparoscopic surgery for the management of colon cancer has increased; however, the feasibility of single-incision laparoscopic colectomy (SILC) for patients with stage IV colon cancer (ST4) has not been well examined.

Fifty-four patients with ST4 could be identified who electively underwent single-incision laparoscopic surgery. In a matched pairs design, 54 patients were then chosen out of a collective of 275 patients undergoing single-incision laparoscopic surgery for stages 0-III colon cancer (ST0-3). Short-term clinical outcomes were assessed, and the overall survival status in ST4 patients was assessed.

The mean length of skin incision was 2.85 cm, and the median operating time and estimated blood loss were 156.1 min and 50.5 g respectively. The mean number of harvested lymph nodes was 20.7. All differences between short-time outcomes were not significant in both groups. The postoperative complication rate was significantly higher and postoperative hospital stay was significantly longer in ST4 patients. The 1-year overall survival rate was 78.5% in ST4 patients. In patients with complication, only postoperative stay was significantly prolonged compared with patients without complication.

Our study indicated mid-term oncological and clinical safety of SILC for patients with ST4.