REVIEW article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1655703
PERIOPERATIVE OUTCOMES OF MULTIPORT OR SINGLE-PORT, TRANSPERITONEAL OR RETROPERITONEAL ROBOT ASSISTED RADICAL NEPHROURETERECTOMY: A NARRATIVE REVIEW
Provisionally accepted
- 1Hôpital Bichat-Claude-Bernard, Paris, France
- 2Comprehensive Cancer Center Wien, Vienna, Austria
- 3Hopital Universitaire Pitie-Salpetriere, Paris, France
- 4Icahn School of Medicine at Mount Sinai, New York, United States
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Background: Robot-assisted radical nephroureterectomy (RARNU), performed via either a multiport or single-port approach through transperitoneal or retroperitoneal routes, is an increasingly utilized surgical method for patients with upper tract urothelial carcinoma. Materials and Methods: A collaborative review of the literature available on Medline was conducted to report the perioperative outcomes of multiport or single-port, transperitoneal or retroperitoneal RARNU. A total of 31 references published between 2006 and 2023 were included. Results: The multiport transperitoneal robotic approach has been documented in 23 studies including between 10 and 3774 RARNU. Operative times ranged from 157 to 326 minutes, intraoperative complication rates from 0% to 7.3%, estimated blood loss from 68.9 mL to 380 mL and blood transfusion rates from 1.4% to 22.7%. Overall postoperative complication ranged from 11.9% to 43.8%, with major complications occurring in 0% to 15.1% of cases. Additionally, the length of hospital stay ranged from 2.3 to 10.3 days. The single-port transperitoneal robotic approach has been documented in 3 studies including between 1 and 12 RANU. Operative time ranged from 160 to 240 minutes, with 17% of patients requiring transfusions. The length of stay varied between 3 and 7 days. Finally, five retrospective studies, including between 2 and 12 patients treated with multiport retroperitoneal RARNU and between 2 and 20 patients with single-port retroperitoneal RARNU were reported, also with satisfactory results. Conclusion: Although prospective comparative studies are needed to confirm these results, RARNU approach, whether single-port or multi-port, transperitoneal or retroperitoneal, appears promising and safe.
Keywords: robot assisted radical nephroureterectomy, Multiport, Single port, Transperitoneal, Retroperitoneal
Received: 28 Jun 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Gabriel, Shariat, Rouprêt, Sfakianos and Xylinas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pierre-Etienne Gabriel, pierre.etienne.aphp@gmail.com
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