Short-term outcomes of single-port versus multi-port robotic surgery for colorectal cancer: a propensity score-matched analysis.

BACKGROUND

Single-port robotic surgery may reduce incision burden compared with multi-port robotic surgery. However, its feasibility for colorectal cancer surgery remains unclear, particularly with respect to short-term surgical outcomes and pathological findings.

METHODS

In this retrospective cohort study, we compared patients with clinical stage I-III colorectal adenocarcinoma who underwent single-port or multi-port robotic colorectal cancer surgery between January 2024 and December 2025. One-to-one propensity score matching was applied to balance baseline confounders. A sensitivity analysis using inverse probability of treatment weighting was also performed to assess robustness.

RESULTS

After matching, 104 patients per group were analyzed. Unadjusted operative time was shorter in the single-port group (median [interquartile range], 203 [165-277] vs. 223 [174-308] minutes; p = 0.042), although multivariable analysis showed no independent association between the platform and operative time. Estimated blood loss did not differ significantly (12 [6-18] vs. 10 [5-24] mL; p = 0.582). C-reactive protein levels on postoperative day (POD) 1 (2.50 [1.78-3.74] vs. 3.17 [1.68-4.95] mg/dL; p = 0.048) and visual analog scale pain scores at 24 h after surgery (8 [0-20] vs. 11 [3-20]; p = 0.038) were lower in the single-port group; however, CRP levels were comparable on POD3 (4.80 [2.64-6.97] vs. 4.97 [2.17-7.03] mg/dL; p = 0.887). The single-port group had fewer incisions and a shorter total incision length (4.7 [4.2-5.2] vs. 7.3 [7.3-8.3] cm; p < 0.001). Pathological findings were comparable, including lymph node yield (18 [11-27] vs. 17 [10-25]; p = 0.560) and radial margin positivity (1.0% vs. 3.8%; p = 0.369). Severe complications and length of stay were similar.

CONCLUSION

Single-port robotic surgery was feasible and achieved perioperative safety comparable to multi-port robotic surgery. It was associated with reduced incision burden and favorable results in selected early postoperative recovery metrics, while showing comparable short-term pathological findings.