Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Propensity Score Matching Comparative Study

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is a standard treatment for prostate cancer.
• Single-port (SP) RARP offers potential advantages in minimally invasive surgery.
• Comparing SP-RARP with traditional multiport (MP) RARP is crucial for understanding its efficacy and outcomes.

Purpose of the Study:

• To compare the perioperative outcomes of SP-RARP and MP-RARP.
• To evaluate functional recovery, including continence and potency, after both procedures.
• To assess nerve-sparing outcomes in patients undergoing SP-RARP versus MP-RARP.

Main Methods:

• Retrospective review of 40 SP-RARP and 129 MP-RARP cases.
• Propensity score matching (1:1) to create comparable cohorts.
• Analysis of perioperative parameters, surgical margins, and functional outcomes (continence, potency, nerve sparing).

Main Results:

• No significant differences were observed in console time, operation time, estimated blood loss, positive surgical margins, or 3-month continence and potency rates between SP-RARP and MP-RARP.
• SP-RARP showed significantly lower rates of complete nerve sparing compared to MP-RARP.
• Despite lower nerve-sparing scores, SP-RARP demonstrated comparable short-term functional results.

Conclusions:

• SP-RARP is a safe and feasible alternative to MP-RARP for radical prostatectomy.
• Short-term functional outcomes, including continence and potency, are comparable between SP-RARP and MP-RARP.
• Further investigation is needed to optimize nerve-sparing techniques in SP-RARP.