Single-port Extraperitoneal and Transperitoneal Radical Prostatectomy: A Multi-Institutional Propensity-Score Matched Study.

To compare the perioperative and early postoperative outcomes between single-port (SP) extraperitoneal radical prostatectomy (EPRP) and SP transperitoneal radical prostatectomy (TPRP), in a multi-institutional setting.

We identified all patients who underwent SP robot-assisted radical prostatectomy (RARP) at six different institutes. Data of 650 patients were collected and divided into two groups based on the surgical approach: SP EPRP or SP TPRP. A Propensity-score matched-pair analysis for body mass index (BMI), prostate size, and National Comprehensive Cancer Network risk (NCCN) was performed with a 1:1 ratio. Analysis of perioperative and postoperative outcomes was performed using Wilcoxon signed-rank test and chi-square and Fisher's exact tests RESULTS: After matching, 238 patients were included in each arm. The median follow-up period was 7 and 6 months for EPRP and TPRP groups, respectively. The total operative time was longer in the EPRP group (206 vs 155 minutes, p<.001). The EPRP group had a shorter length of hospitalization and same-day discharge rate compared to the TPRP approach (p<.001). There was no difference in the overall intraoperative or postoperative complications rate between the two groups, nor positive surgical margin rates CONCLUSION: The SP extraperitoneal approach is associated with a shorter hospital stay and higher rate of same-day discharge, with no difference in the surgical margin, or complication rates.

Urology. 2022 Oct 13 [Epub ahead of print]

Mahmoud Abou Zeinab, Alp Tuna Beksac, Ethan Ferguson, Aaron Kaviani, Marcio Covas Moschovas, Jean Joseph, Moses Kim, Simone Crivellaro, Jeffrey Nix, Vipul Patel, Jihad Kaouk

Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA., Global Robotics Institude, Celebration, Florida, USA., University of Rochester, Rochester, New York, USA., Hoag Hospital, Newport Beach, California, USA., University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA., University of Alabama Birmingham, Birmingham, Alabama, USA., Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: .