Single‑port versus multi‑port robotic-assisted partial nephrectomy: a systematic review and meta-analysis of propensity score-matched cohort studies.
Ruiyan Wang, Lin Zhang, Pengxin Liu et al.
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In 30 seconds
This systematic review and meta-analysis compared single-port (SP) with multi-port (MP) robotic-assisted partial nephrectomy using six retrospective propensity score-matched cohort studies involving 1,223 patients. Primary analyses found no statistically significant differences in positive surgical margins, postoperative complications, major complications, or change in estimated glomerular filtration rate at 6 months. SP was associated with lower estimated blood loss and better early postoperative pain control, although the authors judged these differences small and clinically minimal. Overall, the approaches had comparable oncological, safety, and short-term renal function outcomes.
Key findings
- Six retrospective studies included 1,223 patients: 591 (48%) underwent SP and 632 (52%) underwent MP surgery.
- No statistically significant differences were found in positive surgical margins, postoperative complications, major complications, or ΔeGFR at 6 months.
- SP was associated with lower estimated blood loss and better early postoperative pain control; the differences were small and clinically minimal.
- Primary analyses found no significant differences in operative time, hospital stay, or warm ischemia time.
Why it matters
The findings suggest that SP and MP robotic-assisted partial nephrectomy have broadly comparable short-term oncological, safety, and renal function outcomes in the studied cohorts. The reported differences in blood loss and early pain were small, while possible advantages in operative time and hospital stay emerged only in exploratory sensitivity analyses. This helps frame the evidence without implying established superiority of either approach.
What to keep in mind
The meta-analysis included only six retrospective investigations, so comparisons may be affected by limitations inherent to observational studies. Exploratory findings on operative time and hospital stay require confirmation.