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Comparative Patient-Reported Quality of Life After Single-Port and Multi-Port Robotic Partial Nephrectomy in the Initial Post-Operative Period
Ankur Choksi, MD, Gabriela Nieto Blanco, M.S., Graham Kupsaw, B.S., Sarah Duncan, B.A., Andrew Wagner, MD, Peter Chang, MD MPH.
Beth Israel Deaconess Medical Center, Boston, MA, USA.
BACKGROUND: Minimally invasive approaches to partial nephrectomy have evolved with the introduction of the single port robot. In this study, we compare changes in patient-reported quality-of-life outcomes between patients undergoing single-port vs. multi-port robotic partial nephrectomy.
METHODS: Using our institutional database, we identified patients who underwent robotic partial nephrectomy between 2015 and 2026, and completed validated quality-of-life surveys preoperatively and at 2, 4, 8, and 12 weeks postoperatively. Outcomes included the PCS-12 of the SF-12 and the pain, gastrointestinal, and activity domains of the CARE survey, with higher scores indicating better quality-of-life. A multivariate linear mixed-effects repeated measures regression model with a surgery type-time interaction variable were used to assess longitudinal differences by surgical approach.
RESULTS: A total of 301 patients were identified and differences in demographics and clinical factors are described in Table 1. The cohorts were similar with respect to age, race, sex, BMI, co-morbidities, and history of smoking, depression and anxiety. Tumor size and R.E.N.A.L. nephrometry scores were similar. Surgical approach using a multivariate linear mixed-effects repeated measures model was not significant for PCS-12 (p =0.18), and the CARE pain (p = 0.34), gastrointestinal (p = 0.97), and activity (p=0.30) domains. Analysis of variance of mean post-operative pain scores (p = 0.99) were similar while milligram morphine equivalents on post-operative day 1 (p = 0.01) were different between surgical approaches.
CONCLUSIONS: Patient-reported quality-of-life metrics are similar between patients undergoing single port and multi-port robotic partial nephrectomies.
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