Comparison of outcomes between single-port and multi-port robotic radical nephrectomy.

Publication Title

J Robot Surg

Document Type

Article

Publication Date

11-15-2024

Keywords

washington; swedish; Humans; Nephrectomy; Robotic Surgical Procedures; Female; Male; Middle Aged; Retrospective Studies; Kidney Neoplasms; Treatment Outcome; Operative Time; Aged; Length of Stay; Postoperative Complications; Blood Loss, Surgical

Abstract

Single-port (SP) robotic surgery is a novel technology, and although there is emerging data, it remains limited in assessing single-port (SP) robot-assisted surgery as an alternative to multi-port (MP) platforms. To compare perioperative and postoperative outcomes between SP and MP robotic technologies for radical nephrectomy (RN). This is a retrospective cohort study of patients who have undergone robot-assisted radical nephrectomy using either the SP or MP technology. Baseline demographics, clinical, tumor-specific characteristics, and perioperative and postoperative outcomes were compared using χ2, t-test, Fisher exact test, and Mann-Whitney U test. Multivariable analyses were conducted using robust, Poisson, and logistic regressions. A total of 341 patients underwent robotic RN with 47 patients (14%) in the SP group. The two groups exhibited similar baseline characteristics, with no significant differences in age, sex, body mass index, Charlson comorbidities index, and tumor laterality. However, SP group had a smaller average tumor size (5.1 cm vs 6.4 cm, p = 0.009). The SP had longer operative time (178 ± 84 min vs 142 ± 75 min; p = 0.011) but showed no significant difference in the estimated blood loss, blood transfusion rate, length of stay, overall 30-day and major complication rates. Controlling for other variables, SP was significantly associated with a longer operative time and shorter length of stay. SP is associated with longer operative time but offers advantages such as smaller incisions and shorter hospital stays with a comparative safety profile to MP for radical nephrectomy.

Area of Special Interest

Kidney & Diabetes

Specialty/Research Institute

Nephrology

Specialty/Research Institute

Urology

Specialty/Research Institute

Surgery

DOI

10.1007/s11701-024-02127-x

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