MP24-15 POSITIVE SURGICAL MARGINS AFTER ROBOT-ASSISTED PARTIAL NEPHRECTOMY (RAPN): DOES IT REALLY MATTER? (MARGINS STUDY – UroCCR 96)

Abstract

perioperative outcomes were compared between multiport (MP) and single port (SP) using c 2 , Fisher's exact, and Mann-Whitney U test in the overall cohort and in a 1:1 propensity score-matched cohort, adjusting for baseline characteristics and surgeons.RESULTS: A total of 3,008 patients were included in this study: multiport (n[2,860, 95.08%) and single port (n[148, 4.92%). After propensity matching, 121 (50.00%) SP patients were matched with 121(50.00%) MP patients. Matched SP patients (59 years [IQR: 51, 68]) had similar median age when compared to the MP patients (60 years [IQR: 49, 69]). Compared to matched MP group, the matched SP had a longer median ischemia (16.0 mins [IQR: 11.5, 25.0] vs 13.2 mins [IQR: 10.0, 17.0]; p[0.0001). Although the EBL (50ml [IQR: 25, 100] vs 50ml [IQR: 50, 100]; p[0.002) and LOS (1 day [IQR: 1, 1] vs 1 day [IQR: 1, 2]; p[0.001) were the same, the mean rank sum was significantly lower in the single port groups. Operative time (138 mins [IQR: 113, 170] vs 128 mins [IQR: 90, 174]; p[0.140), positive margin rate (3.31% vs 7.44; p[0.254) and any complication rate (4.96% vs 9.09%; p[ 0.209) were similar between the two groups.CONCLUSIONS: SP partial nephrectomy presented longer ischemia time, lower EBL, lower LOS, similar operative time, similar positive margin and complication rates when compared to multi-port. This early data is encouraging. However, the role of SP requires further study and should evaluate safety and long-term data when compared to the standard multi-port technique.