Propensity Score–Matched Analysis of Extraperitoneal Single-Port vs Intraperitoneal Multiport Radical Prostatectomy
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersOBJECTIVES
To compare the perioperative results and intermediate-term functional outcomes of single port and multiport robotic-assisted laparoscopic prostatectomy by using a propensity-score analysis.
MATERIALS AND METHODS
We evaluated all patients who underwent robotic prostatectomy by three urologic surgeons at our institution between January 2019 and October 2020. Demographic, intraoperative, and postoperative data were collected and assessed. Patients were matched based on body mass index, Gleason group, and prostate volume using the optimal matching method.
RESULTS
Overall, 98 and 165 patients underwent single port and multiport robotic prostatectomy, respectively. Following propensity-score matching, 98 multiport cases were matched 1:1 to single port cases. The median operative time was lower for multiport (111.5 vs 147.0 minutes, p=0.0000). Single port had a lower median estimated blood loss (50.0 vs 75.0 mL, p=0.0006), pain score on postoperative day 0 (1.0 vs 2.0, p=0.0004), opioid use at postoperative day 1 (0.0 [IQR 0.0-5.0] vs 0.0 MME [IQR 0.0-7.5], p=0.0058), cumulative opioid use (2.0 vs 7.0 MME, p=0.0008), and lymph node yield (4.0 vs 7.0 nodes, p=0.0051). Single port had a greater percentage of men regain full erectile function by 6 months (23.8% vs 4.8%, p=0.002).
CONCLUSIONS
The single port robotic system is a safe option for localized prostate cancer treatment, offering superior pain control and comparable perioperative results and intermediate-term functional outcomes compared to the multiport robotic approach.
Additional Info
Propensity-Score Matched Analysis Between Extraperitoneal Single Port and Intraperitoneal Multiport Radical Prostatectomy: A Single-Institutional Experience
Urology 2022 Apr 12;[EPub Ahead of Print], R Harrison, M Stifelman, M Billah, J Zaifman, T Lulla, RS Rosa, H Koster, G Lovallo, M AhmedFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.