Single-port vs multi-port robot-assisted partial nephrectomy: A single center propensity score-matched analysis.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robot-assisted partial nephrectomy (RAPN) is a standard treatment for kidney tumors.
• Single-port (SP) systems offer potential advantages in reduced invasiveness compared to multi-port (MP) systems.
• Comparative data on SP-RAPN versus MP-RAPN outcomes are limited.

Purpose of the Study:

• To compare key perioperative and functional outcomes between SP-RAPN and MP-RAPN.
• To evaluate the achievement of the "Trifecta" outcome in matched SP-RAPN and MP-RAPN cohorts.
• To assess the safety and efficacy of SP-RAPN in an established MP-RAPN program.

Main Methods:

• Retrospective analysis of prospectively collected data from January 2021 to August 2023.
• 1:1 propensity-score matching analysis to control for baseline confounders.
• Comparison of perioperative outcomes and "Trifecta" achievement (negative margins, no high-grade complications, ΔeGFR < 10% at 6 months).

Main Results:

• Thirty SP-RAPN cases were matched to 30 MP-RAPN cases.
• No significant differences were observed in operative time, blood loss, ischemia time, transfusion rates, or complication rates.
• SP-RAPN demonstrated a significantly shorter length of stay (LOS) (25 vs 34 hours, p < 0.003).

Conclusions:

• SP-RAPN is a safe and feasible alternative to MP-RAPN, even in centers with established MP-RAPN programs.
• Key surgical and short-term functional outcomes are comparable between SP-RAPN and MP-RAPN.
• SP-RAPN facilitates faster recovery and shorter LOS, supporting its potential for outpatient robotic surgery.