Single-versus multi-port robotic partial nephrectomy: a meta-analytic study of perioperative, functional, and oncologic outcomes.

Three databases were searched for studies evaluating SP versus MP RAPN. Continuous outcomes were pooled as mean differences (MD) and binary variables as odds ratios (OR) with 95% confidence intervals (CI). Fixed- or random-effects models were applied depending to heterogeneity. Prespecified subgroup analyses were conducted based on propensity-score matching and surgical approach. Fifteen studies comprising 2,689 patients (902 SP and 1,787 MP) were included, predominantly retrospective cohorts, with eight propensity-score–matched analyses. Four studies were of good quality and eleven were fair quality. Compared with MP RAPN, SP RAPN was associated with lower estimated blood loss (MD − 15.72 mL; 95%CI: −23.73 to − 7.71), shorter length of stay (MD − 0.43 days; 95%CI: −0.84 to − 0.20), and lower postoperative pain scores (MD − 0.33 on VAS; 95%CI: −0.59 to − 0.08). Ischemia time was longer with SP RAPN (MD 6.06 min; 95%CI: 0.98 to 11.14). Operative time, postoperative eGFR, oncologic outcomes, complications, and mortality were comparable between groups, with subgroup analyses showing no consistent effect modification. SP RAPN appears to provide perioperative and short-term oncologic outcomes comparable to MP RAPN, with modest improvements in selected recovery parameters. Differences in ischemia time remain uncertain due to substantial heterogeneity and low certainty of evidence.