Single-site multiport vs. conventional multiport robot-assisted radical prostatectomy: A propensity score matching comparative study

Objective: Robot-assisted radical prostatectomy (RARP) is a dynamically evolving technique with its new evolution of single-site RARP. Here we sought to describe our extraperitoneal technique, named the single-site multiport RARP (ssmpRARP) using the da Vinci Si (R) platform and compare it with the transperitoneal conventional multiport RARP (cmpRARP). Materials and Methods: Data were retrospectively collected for patients who underwent RARP for localized prostate cancer from June 2020 to January 2022 in a single center. Propensity score matching was performed based on age, prostate size, body mass index, neoadjuvant hormonal therapy usage, prostate-specific antigen levels, and clinical T stage. The differences between the matched two groups were investigated. Results: Of the patients, 20 underwent ssmpRARP and 42 underwent cmpRARP during the period. After matching, 18 patients from each group were selected. Median follow-up was 7.8 months (2-12 months) for the ssmpRARP group, and 15.0 months (3-26 months) for cmpRARP. The demographic features between the two groups were comparable. The median total operative time, estimated blood loss, pathologic data, early follow-up outcomes, and hospitalization stays and costs were similar between the two groups. The ssmpRARP group tended to return to their bowel activities earlier (44.78 +/- 10.83 h vs. 54.89 +/- 12.97 h, p = 0.016). There were no significant differences in complication rates. Conclusions: We demonstrated the feasibility and safety of performing extraperitoneal ssmpRARP using the da Vinci Si (R) robotic platform. Our technique showed comparable short-term outcomes with the transperitoneal cmpRARP. Prospective trials and long-term follow-up are necessary to confirm these results.