Low incidence of venous thromboembolic complications following single-port robotic surgeries for upper and lower tract urological malignancies: a report from the Single-Port Advanced Research Consortium (SPARC)

TL;DR

This study found a very low risk of blood clots after single-port robotic surgeries for urological cancers, with risk tools like Caprini helping identify patients who might need extra care.

Contribution

The study provides the first multi-institutional data on venous thromboembolism (VTE) rates following single-port robotic surgeries for urological malignancies.

Findings

No venous thromboembolic events (VTE) occurred after single-port robotic partial nephrectomy (RAPN).

A 0.44% overall VTE incidence was observed across single-port robotic procedures for urological malignancies.

Higher Caprini scores correlated with increased odds of VTE following single-port robotic radical prostatectomy (RARP).

Abstract

With the increasing utility of the single-port (SP) robotic platform, there remains limited evidence surrounding the perioperative morbidity associated with the novel techniques. This study sought to evaluate the incidence of venous thromboembolic events (VTE) associated with the SP procedures for upper and lower tract urological malignancies, based on the multi-institutional experience of the Single-Port Advanced Research Consortium (SPARC), involving a total of 2286 patients. The group comprised 1886 (82.5%) and 400 (17.5%) cases of SP robotic radical prostatectomy (RARP) and SP robotic partial nephrectomy (RAPN) that were completed between 2018 and 2024. In addition to the perioperative variables, all patients were stratified into low, moderate, and high risk for VTE according to the Caprini scoring system. Notably, no cases of VTE were identified following SP-RAPN, while eight cases of DVT (0.42%) and two cases of PE (0.11%) were diagnosed following SP-RARP. Appreciating the different risk factors of VTE, a higher Caprini score was identified to be associated with VTE, with every one-point increase in the score contributing to 1.6 times higher odds of VTE following SP-RARP. In summary, this study demonstrated the relatively low incidence of VTE associated with SP robotic procedures for upper and lower tract urological malignancies (0.44%). The utility of validated tools such as the Caprini scoring system can provide additional benefits to identify at-risk patients and provide foundations for further research to better select candidates for mechanical and pharmacological thromboprophylaxis and, thus, ensure satisfactory perioperative outcomes.

The online version contains supplementary material available at 10.1007/s11701-025-02796-2.

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