Single Port Versus Multiport Robot-assisted Simple Prostatectomy: A Multi-institutional Study From the Single-port Advanced Research Consortium (SPARC)
Abou Zeinab M, Ramos R, Ferguson EL, Okhawere KE, Iarajuli T, Wilder S, Calvo RS, Chavali JS, Saini I, De La Rosa RS, Nguyen J, Crivellaro S, Rogers C, Stifelman M, Ahmed M, Badani K, and Kaouk J. Single Port Versus Multiport Robot-assisted Simple Prostatectomy: A Multi-institutional Study From the Single-port Advanced Research Consortium (SPARC). Urology 2023.
OBJECTIVE: To compare robot-assisted simple prostatectomy intraoperative and postoperative outcomes between single-port (SP) and multiport (MP) robotic systems in a multi-institutional setting.
METHODS: We analyzed all-consecutive robot-assisted simple prostatectomy cases done in 5 centers from January 2017 to October 2022. Data were analyzed with descriptive statistics and compared with appropriate tests depending on the type of variable and distribution. Statistical significance was considered when P <.05.
RESULTS: A total of 405 cases were analyzed: 249 and 156 were MP and SP, respectively. Operative times were similar between groups (P = .62). Estimated blood loss during surgery was significantly lower with the SP robot (P <.001). Postoperatively, the SP approach required a significantly shorter hospital stay, less use of opioids, and a shorter duration of Foley catheter (P <.001). There was no significant difference between the post-operative Clavien-Dindo ≥3 complication rate (P = .30). The 30-day readmission rate of MP (10.8%) was significantly higher than for SP (0%) (P <.001). De novo urge incontinence was more common in the MP group (P = .02).
CONCLUSION: The SP robotic approach to simple prostatectomy is advantageous when it comes to postoperative comfort for patients. Specifically, it requires a shorter hospital stay, less use of opioids, and a shorter Foley catheter duration.
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