Less pain and earlier recovery after extra-thoracic single-port robotic lung resection: a propensity-matched comparison.

We compare patients’ postoperative pain on the day of surgery and their analgesic use at their 2-week follow-up visit who underwent SP subcostal versus MP intercostal robotic pulmonary resection. A total of 2,613 robotic thoracic lung resections performed between July 2016 and October 2025 were screened. A retrospective, propensity-matched cohort of 164 patients (41 SP, 123 MP) was analyzed and matched 1:3 by age, gender, ASA class, BMI, and ethnicity. Postoperative pain was assessed using the Numeric Rating Scale (0–10) during the first 18 h. Analgesic consumption was assessed at the 2-week follow-up visit. From December 2022 to October 2025, 41 patients underwent SP robotic pulmonary resection and were propensity-matched to 123 MP patients. Lymph node yield was comparable for lobectomy (SP 29 ± 10 vs. MP 32 ± 11; p = .24) and sublobar resection (SP 24 ± 13 vs. MP 25 ± 10; p = .71). Operative time was longer in SP lobectomy (152.6 ± 34.4 vs. 128.7 ± 45.0 min; p = .01). Postoperative pain scores were lower in the SP group at all assessed intervals: 1–3, 3–10, and 10–18 h (p < .05). At the 2-week follow-up visit, patients in the SP group had lower analgesic use (p≤ .042). Single-port robotic pulmonary resection may be associated with lower early postoperative pain and reduced analgesic consumption at 2 weeks compared with multiport robotic resection. Prospective, multi-institutional studies are required to evaluate these findings.