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

Abstract

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