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

Abstract

Purpose:

The aim of this study was to compare the perioperative outcomes of patients who underwent single-port (SP) robot-assisted radical prostatectomy (RARP) (SP-RARP) with those who underwent multiport (MP) RARP (MP-RARP).

Methods:

Data on 40 consecutive patients who underwent SP-RARP between June 2020 and February 2021 and 129 who underwent MP-RARP between June 2019 and February 2021 were retrospectively reviewed. Using logistic regression, 31 patients who underwent SP-RARP were matched to 31 patients who underwent MP-RARP (1:1) based on propensity scores. The available perioperative parameters and outcomes were analyzed.

Results:

Compared with MP-RARP, SP-RARP showed no significant differences in perioperative parameters, including the console time (111.0 ± 15.7 vs 102.6 ± 18.8 minutes, p = 0.569), operation time (151.3 ± 15.1 vs 158.7 ± 20.3 minutes, p = 0.863), estimated blood loss (121.1 ± 64.7 vs 140.5 ± 90.5 mL, p = 0.638), positive surgical margins (19.4% in both groups), and 3-month continence (77.4% vs 83.9%, p = 0.563) and potency (45.2% vs 48.4%, p = 0.891) rates. Patients who underwent SP-RARP had lower proportions of complete nerve sparing than those who underwent MP-RARP (SP-RARP vs MP-RARP in subjective scores: 4.0 ± 0.8 vs 4.4 ± 0.9, p = 0.046; SP-RARP vs MP-RARP in pathologic score of 5, 35.5% vs 64.5%, p = 0.049; score of 4, 41.9% vs 19.4%, p = 0.038; score of 3, 19.4% vs 9.7%, p = 0.398; score of 2, 3.2% vs 0.0%, p = 0.365; and score of 1, 3.2% vs 3.2%, p = 0.932, respectively).

Conclusions:

SP-RARP showed lower nerve-sparing scores than MP-RARP. The present study suggests that SP-RARP is safe and feasible with short-term functional outcomes comparable to those of MP-RARP.