Single-port versus multi-port robot-assisted partial nephrectomy for predominantly low-complexity renal tumors: a systematic review and meta-analysis.

Single-port robot-assisted partial nephrectomy (SP-RAPN) is increasingly used for selected renal tumors, but its comparative value over multi-port robot-assisted partial nephrectomy (MP-RAPN) remains uncertain. We performed a systematic review and meta-analysis of comparative studies, prioritizing propensity score-matched data when available. PubMed, Scopus, Web of Science, and Google Scholar were searched. Three studies involving 442 patients were included (210 SP-RAPN and 232 MP-RAPN). SP-RAPN was associated with lower estimated blood loss (MD = - 16.62 mL, 95% CI - 32.35 to - 0.89; P = 0.04; I² = 0%), although the absolute difference was small and unlikely to be clinically meaningful. No clear differences were detected in operative time, ischemia time, length of hospital stay, postoperative complications, positive surgical margins, or pathological stage distribution. Ischemia-time estimates were difficult to interpret because of marked heterogeneity. Overall, the available evidence does not demonstrate a clear short-term advantage of either approach in predominantly low-complexity renal tumors. Given the small number of non-randomized cohorts and residual risk of bias, these findings should not be interpreted as evidence of equivalence or superiority. Larger prospective multicenter studies are needed.