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Single Port Donor Nephrectomy
Published on: March 12, 2011
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A Single Port (SP) Approach Reduces the Risk of Postoperative Complications in Elderly Patients Undergoing
Valerio Santarelli1,2, Fabio Maria Valenzi2,3, Hakan Bahadır Haberal2,4
1Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, 00185 Rome, Italy.
Cancers
|April 26, 2025
Summary
Single Port Robotic-Assisted Partial Nephrectomy (SP RAPN) is safe and effective for elderly patients with localized Renal Cell Carcinoma (RCC). SP RAPN demonstrated lower complication rates, reduced blood loss, and shorter hospital stays compared to Multi Port RAPN.
Area of Science:
- Urology
- Oncology
- Minimally Invasive Surgery
Background:
- Increasing life expectancy leads to more elderly patients undergoing Robotic-Assisted Partial Nephrectomy (RAPN) for localized Renal Cell Carcinoma (RCC).
- Nephron Sparing Strategies (NSS) are increasingly popular, necessitating evaluation of surgical approaches in frail populations.
- Single Port (SP) approaches have shown potential benefits in reducing complications and hospital stay compared to Multi Port (MP) techniques.
Purpose of the Study:
- To compare perioperative and postoperative outcomes of SP RAPN versus MP RAPN.
- To specifically evaluate outcomes in elderly and frail patients undergoing these procedures.
- To identify predictors of 30-day postoperative complications in patients undergoing RAPN.
Main Methods:
- Retrospective review of 293 localized RCC patients who underwent MP or SP RAPN (2018-2024).
- Patients were stratified into younger (<65 years) and elderly (≥65 years) groups.
- Univariate and multivariate regression analyses were performed to assess complication risk factors, particularly in elderly patients.
Main Results:
- SP RAPN cohorts showed significantly higher rates of extraperitoneal access and shorter operative times and length of stay (LOS) in both age groups.
- SP RAPN required longer median ischemia times but resulted in significantly lower estimated blood loss (EBL) in elderly patients.
- Multivariate analysis identified SP approach as an independent predictor of lower 30-day postoperative complications (OR: 0.2, 95%CI 0.04-0.9, p=0.04).
Conclusions:
- Elderly patients undergoing SP RAPN experienced comparable or lower complication rates, EBL, and hospitalization days than younger counterparts.
- The SP approach was found to be protective against 30-day postoperative complications.
- SP RAPN is a feasible and safe surgical option for older and potentially frailer patients with localized RCC.
