J Robot Surg. 2025 Sep 29;19(1):643. doi: 10.1007/s11701-025-02693-8.
ABSTRACT
To compare perioperative and oncologic outcomes between single-port (SP) and multi-port (MP) retroperitoneal robotic-assisted partial nephrectomy (RAPN) in obese patients with renal tumors. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Web of Science up to July 2025. Eligible studies were those directly comparing SP-RAPN with MP-RAPN in obese patients (BMI ≥30 kg/m2). Extracted data included operative duration, intraoperative blood loss, warm ischemia time, length of hospitalization, complication rates, and oncologic outcomes, which were synthesized using RevMan 5.4. Three retrospective studies involving 694 patients (252 SP, 442 MP) were included. SP-RAPN was associated with a shorter hospital stay (WMD = -0.29 days, P = 0.02) but a longer warm ischemia time (WMD = 5.23 min, P < 0.00001). No significant differences were observed in operative time, estimated blood loss, complication rate, or positive surgical margins. The SP group had higher tumor complexity based on R.E.N.A.L. nephrometry scores. SP-RAPN demonstrates comparable safety and oncologic outcomes to MP-RAPN in obese patients, with the added benefit of reduced hospital stay. However, increased ischemia time should be considered when selecting the surgical approach. High-quality prospective trials are needed to confirm these findings.
PMID:41021133 | DOI:10.1007/s11701-025-02693-8
