Background/Objectives: Single-port radical prostatectomy (SP-RARP) has been demonstrated to be a feasible and safe procedure, even in older patients. This study aims to compare multi-port radical prostatectomy (MP-RARP) with SP-RARP, with a particular focus on elderly patients.Methods: Patients who underwent SP-RARP or MP-RARP between January 2018 and December 2023 were retrospectively analyzed. Patients undergoing concomitant surgical procedures or diagnosed with locally advanced prostate cancer were excluded from this study. Patients were then stratified into two groups: Group A (age < 65 years) and Group B (age ≥ 65 years).Results: A total of 338 patients (153 MP-RARP and 185 SP-RARP) were retrospectively collected. In Group B, the length of stay (in hours) was significantly shorter for SP procedures compared to MP (18 (20.8) vs. 35 (17);p= 0.002), with a higher rate of same-day discharge in favor of SP (45 (54.9%) vs. 9 (16.7%);p< 0.001). Additionally, MP patients in Group B had a higher incidence of postoperative complications at both 30 days (19(35.2%) vs. 13 days (15.9%);p= 0.009) and 90 days (21(38.9%) vs. 14 days (17.1%);p= 0.004) compared to those undergoing SP. Multivariable logistic regression analysis identified SP as a protective factor against postoperative complications at 30 days (Odds ratio: 0.41; 95% CI: 0.15, 0.97;pvalue = 0.027) and 90 days (Odds ratio: 0.38; 95% CI: 0.17,0.788;p= 0.024). Additionally, length of stay was associated with postoperative complications at 30 days (Odds ratio: 1.02; 95% CI: 1.01, 1.13;pvalue = 0.046).Conclusions: SP-RARP is a safe and feasible option for elderly patients, offering a lower incidence of short-term postoperative complications compared to MP-RARP. Furthermore, same-day discharge is feasible even in elderly patients undergoing SP-RARP.
背景/目的：单孔机器人辅助根治性前列腺切除术（SP-RARP）已被证实是一种可行且安全的手术方式，即使在老年患者中亦是如此。本研究旨在比较多孔机器人辅助根治性前列腺切除术（MP-RARP）与SP-RARP，并特别关注老年患者群体。 方法：本研究回顾性分析了2018年1月至2023年12月期间接受SP-RARP或MP-RARP的患者。同时接受其他手术或诊断为局部晚期前列腺癌的患者被排除在外。患者随后被分为两组：A组（年龄<65岁）和B组（年龄≥65岁）。 结果：共回顾性收集了338例患者（153例MP-RARP，185例SP-RARP）。在B组（老年组）中，SP-RARP患者的住院时间（以小时计）显著短于MP-RARP患者（18 (20.8) 小时 vs. 35 (17) 小时；p=0.002），且SP-RARP患者的当日出院率更高（45例 (54.9%) vs. 9例 (16.7%)；p<0.001）。此外，与接受SP-RARP的患者相比，B组中接受MP-RARP的患者在术后30天（19例 (35.2%) vs. 13例 (15.9%)；p=0.009）和90天（21例 (38.9%) vs. 14例 (17.1%)；p=0.004）的并发症发生率更高。多变量逻辑回归分析确定，SP-RARP是术后30天（比值比：0.41；95% CI：0.15, 0.97；p值=0.027）和90天（比值比：0.38；95% CI：0.17, 0.788；p=0.024）并发症的保护因素。此外，住院时间与术后30天并发症相关（比值比：1.02；95% CI：1.01, 1.13；p值=0.046）。 结论：对于老年患者而言，SP-RARP是一种安全可行的选择，与MP-RARP相比，其短期术后并发症发生率更低。此外，即使是接受SP-RARP的老年患者，当日出院也是可行的。
Single-Port Versus Multi-Port Robotic Radical Prostatectomy in Elderly Patients
肿瘤(癌症)患者之家