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Prostate Cancer: Localized: Surgical Therapy III (MP50): Moderated Poster 50: Sunday, September 12, 2021

MP50-19 MATCHED ANALYSIS OF PERIOPERATIVE OUTCOMES BETWEEN EXTRAPERITONEAL SINGLE PORT AND INTRAPERITONEAL MULTIPORT PROSTATECTOMY: A SINGLE-INSTITUTIONAL EXPERIENCE

Harrison, Robert; Stifelman, Michael; Billah, Shabil; Lulla, Tina; Lovallo, Greg; Ahmed, Mutahar

doi: 10.1097/JU.0000000000002076.19
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INTRODUCTION AND OBJECTIVE:

This study seeks to compare perioperative outcomes between single port (SP) and multiport (MP) robot-assisted laparoscopic radical prostatectomy (RALP) cases utilizing propensity score matching.

METHODS:

A retrospective chart review was performed on patients who underwent either MP or SP-RALP at our institution between 1/1/2019 and 10/1/2020. To minimize variation due to different surgeons, only SP-RALP and MP-RALPs performed by the same three surgeons were included. Patients were matched (1:1) on BMI, Gleason group and prostate volume using the optimal matching method. Categorical variables were compared using McNemar’s test while continuous variables were compared using Wilcoxon signed-rank test.

RESULTS:

In all, 196 patients were included after propensity score matching (98 MP and SP). Table 1 summarizes the cohort’s demographic characteristics. There were no differences between the groups, with the exception of clinical T stage, in which the SP group had a greater percentage of T1c cases (94.9% vs 85.7%, p=0.0390). Outcome data is presented in Table 2. SP was associated with lower median estimated blood loss (50.0 vs. 75.0, p=0.0006), pain scores POD 0 (1.0 vs 2.0, p=0.0004), opioid use at POD 1 (0.0 vs 0.0, p=0.0058) and cumulative opioid use at discharge (2.0 vs 7.0, p=0.0008). MP was found to have shorter median operative time (111.5 vs 147.0, p=0.0000) and higher lymph node yield (6.0 vs 3.5, p=0.0019).

CONCLUSIONS:

Our early experience with SP-RALP suggest it is safe, reproducible and potentially offers better pain control, as evidenced by lower POD 0 pain scores and opioid use POD 1. The increased OR time was likely due to more experience with MP and may suggest a learning curve when transitioning from MP to SP-RALP. Given increased OR time and a decrease in nodal count future research should address the challenges to surgeons in switching from SP to MP.

Source of Funding:

none

© 2021 by American Urological Association Education and Research, Inc.