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

Background: 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. Methods: 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. Results: 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. Conclusions: Our study indicated mid-term oncological and clinical safety of SILC for patients with ST4.