Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy

Kennedy E. Okhawere; Alp Tuna Beksac; Ethan Ferguson; Laura Zuluaga; Indu Saini; Burak Ucpinar; Ruben C. Sauer; Mutahar Ahmed; Reza Mehrazin; Ronney Abaza; Daniel D. Eun; Akshay Bhandari; Michael D. Stifelman; Jihad Kaouk; Simone Crivellaro; Ketan K. Badani

doi:10.1016/j.urolonc.2024.09.017

Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy

Kennedy E. Okhawere, Alp Tuna Beksac, Ethan Ferguson, Laura Zuluaga, Indu Saini, Burak Ucpinar, Ruben C. Sauer, Mutahar Ahmed, Reza Mehrazin, Ronney Abaza, Daniel D. Eun, Akshay Bhandari, Michael D. Stifelman, Jihad Kaouk, Simone Crivellaro, Ketan K. Badani

School of Medicine

Hackensack Meridian School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Single-port (SP) robotic surgical system performs well in small anatomical spaces, which makes it suitable for retroperitoneal robotic partial nephrectomy (RPN). However, there is limited evidence comparing the safety and feasibility of SP RPN to multiport (MP) RPN. To address this gap in evidence, we sought to analyze and compare the safety of retroperitoneal RPN between SP and MP approaches. Methods: This is a retrospective cohort study using data from the Single Port Advanced Research Consortium (SPARC) and a multicenter database of patients who underwent retroperitoneal RPN using either SP or MP between 2017 and 2023. Baseline, perioperative, and postoperative data were compared using t-tests, Mann-Whitney U test, χ² test, and Fisher exact test. Multivariable analyses were conducted using robust and Poisson regressions. Results: A total of 286 patients (SP RPN, n = 86 [30%]; MP RPN, n = 200 [70%]) underwent retroperitoneal RPN. R.E.N.A.L nephrometry score and tumor location were significantly different between the 2 groups. Notably, the ischemia time was significantly shorter in the MP group (16 vs. SP, 22 minutes, P < 0.001). Adjusting for baseline characteristics, the ischemia time was approximately 7.89 minutes longer for patients in the SP group compared to the MP group, on average (95% CI: 5.87, 9.92; P < 0.001). No significant differences were observed in operative time, EBL, blood transfusion, conversion rates, LOS, PSM, and overall 30-day postoperative complications between the 2 groups. Conclusion: Our study shows that retroperitoneal SP and MP RPN have comparable perioperative and postoperative outcomes, except for the longer ischemia time in the SP platform. SP RPN is a safe and viable alternative; however, further research is needed to explore its potential benefits, cost-effectiveness, and long-term oncologic outcomes.

Original language	English
Pages (from-to)	63.e1-63.e6
Journal	Urologic Oncology
Volume	43
Issue number	1
DOIs	https://doi.org/10.1016/j.urolonc.2024.09.017
State	Published - Jan 2025

ASJC Scopus subject areas

Oncology
Urology

Keywords

Partial nephrectomy
Perioperative outcome
Robotic surgery
Single port

Access to Document

10.1016/j.urolonc.2024.09.017

Cite this

Okhawere, K. E., Beksac, A. T., Ferguson, E., Zuluaga, L., Saini, I., Ucpinar, B., Sauer, R. C., Ahmed, M., Mehrazin, R., Abaza, R., Eun, D. D., Bhandari, A., Stifelman, M. D., Kaouk, J., Crivellaro, S., & Badani, K. K. (2025). Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy. Urologic Oncology, 43(1), 63.e1-63.e6. https://doi.org/10.1016/j.urolonc.2024.09.017

@article{6e860b57ae674a11bf82f955990c58fd,

title = "Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy",

abstract = "Introduction: Single-port (SP) robotic surgical system performs well in small anatomical spaces, which makes it suitable for retroperitoneal robotic partial nephrectomy (RPN). However, there is limited evidence comparing the safety and feasibility of SP RPN to multiport (MP) RPN. To address this gap in evidence, we sought to analyze and compare the safety of retroperitoneal RPN between SP and MP approaches. Methods: This is a retrospective cohort study using data from the Single Port Advanced Research Consortium (SPARC) and a multicenter database of patients who underwent retroperitoneal RPN using either SP or MP between 2017 and 2023. Baseline, perioperative, and postoperative data were compared using t-tests, Mann-Whitney U test, χ2 test, and Fisher exact test. Multivariable analyses were conducted using robust and Poisson regressions. Results: A total of 286 patients (SP RPN, n = 86 [30%]; MP RPN, n = 200 [70%]) underwent retroperitoneal RPN. R.E.N.A.L nephrometry score and tumor location were significantly different between the 2 groups. Notably, the ischemia time was significantly shorter in the MP group (16 vs. SP, 22 minutes, P < 0.001). Adjusting for baseline characteristics, the ischemia time was approximately 7.89 minutes longer for patients in the SP group compared to the MP group, on average (95% CI: 5.87, 9.92; P < 0.001). No significant differences were observed in operative time, EBL, blood transfusion, conversion rates, LOS, PSM, and overall 30-day postoperative complications between the 2 groups. Conclusion: Our study shows that retroperitoneal SP and MP RPN have comparable perioperative and postoperative outcomes, except for the longer ischemia time in the SP platform. SP RPN is a safe and viable alternative; however, further research is needed to explore its potential benefits, cost-effectiveness, and long-term oncologic outcomes.",

keywords = "Partial nephrectomy, Perioperative outcome, Robotic surgery, Single port",

author = "Okhawere, {Kennedy E.} and Beksac, {Alp Tuna} and Ethan Ferguson and Laura Zuluaga and Indu Saini and Burak Ucpinar and Sauer, {Ruben C.} and Mutahar Ahmed and Reza Mehrazin and Ronney Abaza and Eun, {Daniel D.} and Akshay Bhandari and Stifelman, {Michael D.} and Jihad Kaouk and Simone Crivellaro and Badani, {Ketan K.}",

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier Inc.",

year = "2025",

month = jan,

doi = "10.1016/j.urolonc.2024.09.017",

language = "English",

volume = "43",

pages = "63.e1--63.e6",

journal = "Urologic Oncology",

issn = "1078-1439",

publisher = "Elsevier Inc.",

number = "1",

}

Okhawere, KE, Beksac, AT, Ferguson, E, Zuluaga, L, Saini, I, Ucpinar, B, Sauer, RC, Ahmed, M, Mehrazin, R, Abaza, R, Eun, DD, Bhandari, A, Stifelman, MD, Kaouk, J, Crivellaro, S & Badani, KK 2025, 'Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy', Urologic Oncology, vol. 43, no. 1, pp. 63.e1-63.e6. https://doi.org/10.1016/j.urolonc.2024.09.017

TY - JOUR

T1 - Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy

AU - Okhawere, Kennedy E.

AU - Beksac, Alp Tuna

AU - Ferguson, Ethan

AU - Zuluaga, Laura

AU - Saini, Indu

AU - Ucpinar, Burak

AU - Sauer, Ruben C.

AU - Ahmed, Mutahar

AU - Mehrazin, Reza

AU - Abaza, Ronney

AU - Eun, Daniel D.

AU - Bhandari, Akshay

AU - Stifelman, Michael D.

AU - Kaouk, Jihad

AU - Crivellaro, Simone

AU - Badani, Ketan K.

PY - 2025/1

Y1 - 2025/1

N2 - Introduction: Single-port (SP) robotic surgical system performs well in small anatomical spaces, which makes it suitable for retroperitoneal robotic partial nephrectomy (RPN). However, there is limited evidence comparing the safety and feasibility of SP RPN to multiport (MP) RPN. To address this gap in evidence, we sought to analyze and compare the safety of retroperitoneal RPN between SP and MP approaches. Methods: This is a retrospective cohort study using data from the Single Port Advanced Research Consortium (SPARC) and a multicenter database of patients who underwent retroperitoneal RPN using either SP or MP between 2017 and 2023. Baseline, perioperative, and postoperative data were compared using t-tests, Mann-Whitney U test, χ2 test, and Fisher exact test. Multivariable analyses were conducted using robust and Poisson regressions. Results: A total of 286 patients (SP RPN, n = 86 [30%]; MP RPN, n = 200 [70%]) underwent retroperitoneal RPN. R.E.N.A.L nephrometry score and tumor location were significantly different between the 2 groups. Notably, the ischemia time was significantly shorter in the MP group (16 vs. SP, 22 minutes, P < 0.001). Adjusting for baseline characteristics, the ischemia time was approximately 7.89 minutes longer for patients in the SP group compared to the MP group, on average (95% CI: 5.87, 9.92; P < 0.001). No significant differences were observed in operative time, EBL, blood transfusion, conversion rates, LOS, PSM, and overall 30-day postoperative complications between the 2 groups. Conclusion: Our study shows that retroperitoneal SP and MP RPN have comparable perioperative and postoperative outcomes, except for the longer ischemia time in the SP platform. SP RPN is a safe and viable alternative; however, further research is needed to explore its potential benefits, cost-effectiveness, and long-term oncologic outcomes.

AB - Introduction: Single-port (SP) robotic surgical system performs well in small anatomical spaces, which makes it suitable for retroperitoneal robotic partial nephrectomy (RPN). However, there is limited evidence comparing the safety and feasibility of SP RPN to multiport (MP) RPN. To address this gap in evidence, we sought to analyze and compare the safety of retroperitoneal RPN between SP and MP approaches. Methods: This is a retrospective cohort study using data from the Single Port Advanced Research Consortium (SPARC) and a multicenter database of patients who underwent retroperitoneal RPN using either SP or MP between 2017 and 2023. Baseline, perioperative, and postoperative data were compared using t-tests, Mann-Whitney U test, χ2 test, and Fisher exact test. Multivariable analyses were conducted using robust and Poisson regressions. Results: A total of 286 patients (SP RPN, n = 86 [30%]; MP RPN, n = 200 [70%]) underwent retroperitoneal RPN. R.E.N.A.L nephrometry score and tumor location were significantly different between the 2 groups. Notably, the ischemia time was significantly shorter in the MP group (16 vs. SP, 22 minutes, P < 0.001). Adjusting for baseline characteristics, the ischemia time was approximately 7.89 minutes longer for patients in the SP group compared to the MP group, on average (95% CI: 5.87, 9.92; P < 0.001). No significant differences were observed in operative time, EBL, blood transfusion, conversion rates, LOS, PSM, and overall 30-day postoperative complications between the 2 groups. Conclusion: Our study shows that retroperitoneal SP and MP RPN have comparable perioperative and postoperative outcomes, except for the longer ischemia time in the SP platform. SP RPN is a safe and viable alternative; however, further research is needed to explore its potential benefits, cost-effectiveness, and long-term oncologic outcomes.

KW - Partial nephrectomy

KW - Perioperative outcome

KW - Robotic surgery

KW - Single port

UR - http://www.scopus.com/inward/record.url?scp=85205935447&partnerID=8YFLogxK

U2 - 10.1016/j.urolonc.2024.09.017

DO - 10.1016/j.urolonc.2024.09.017

M3 - Article

C2 - 39379208

SN - 1078-1439

VL - 43

SP - 63.e1-63.e6

JO - Urologic Oncology

JF - Urologic Oncology

IS - 1

ER -

Comparison of outcomes between single-port and multiport retroperitoneal robotic partial nephrectomy

Abstract

ASJC Scopus subject areas

Keywords

Access to Document

Other files and links

Fingerprint

Cite this