Journal Article

Early patient‐reported outcomes after robotic‐assisted versus video‐assisted thoracoscopic lobectomy

Zhou, Haiyu, Qiao, Guibin, Deng, Cheng, Tang, Yong, Chen  , Rixin, Li, Xianglin, Ben, Xiaosong, Zeng, Cheng, Xia, Xin, Lan, Zihua, Li, Zijie, Shi, Qiuling, Mo, Aotian

2024

Overview

Background Robotic‐assisted thoracoscopic surgery (RATS) can achieve traditional clinical outcomes comparable to those of video‐assisted thoracoscopic surgery (VATS). However, patient‐reported outcomes (PROs) during the early period after RATS and VATS remain unclear. This study aimed to utilize longitudinal electronic PRO (ePRO) assessments to evaluate symptom burden and functional status between these approaches from patients' perspective. Methods This study comprised patients who underwent lobectomy via RATS or VATS for non‐small cell lung cancer. We collected multiple‐time‐point PROs data from the prospective longitudinal study via an ePRO system. Symptom severity and function status were assessed using the perioperative symptom assessment for patients undergoing lung surgery and were analyzed between groups using linear mixed‐effects models. Results Of the 164 patients, 42 underwent RATS and 122 underwent VATS. After propensity score matching (PSM), 42 RATS and 84 VATS exhibited similar baseline characteristics. During the 7‐day postoperative period, participants underwent RATS reported milder pain (p = 0.014), coughing (p < 0.001), drowsiness (p = 0.001), and distress (p = 0.045) compared with those underwent VATS. Moreover, participants in RATS group showed less functional interference with walking (p < 0.001) and general activity (p < 0.001). RATS exhibited a shorter postoperative hospitalization (p = 0.021) but higher hospital cost (p < 0.001). Meanwhile, short‐term clinical outcomes of operative time, dissected lymph node stations, chest tube drainage, and postoperative complication rates were comparable. Conclusion PROs are important metrics for assessing patients' recovery after lobectomy. Compared with VATS, RATS may induce less symptom burden and better functional status for patients in the early postoperative period. Key question: Are there any advantages of robotic‐assisted thoracoscopic surgery (RATS) compared to video‐assisted thoracoscopic surgery (VATS) from the patient's perspective? Key findings: Patients who underwent RATS lobectomy for lung cancer experienced less pain, coughing, drowsiness, and distress, as well as less impairment in walking and activity. Take‐home message: RATS lobectomy can achieve comparable traditional clinical outcomes to VATS. Notably, RATS yields milder symptoms and better functional status than VATS.

• Publisher: John Wiley & Sons Australia, Ltd,John Wiley & Sons, Inc,Wiley
• Subject: Aged / Body mass index / Cancer surgery / Carcinoma, Non-Small-Cell Lung - pathology / Carcinoma, Non-Small-Cell Lung - surgery / Chest tubes / Classification / Clinical outcomes / Demographics / Female / Hospital costs / Hospitals / Humans / Longitudinal Studies / Lung cancer / Lung Neoplasms - pathology / Lung Neoplasms - surgery / Lymphatic system / Male / Middle Aged / non‐small cell lung cancer / Original / Parameter estimation / Patient Reported Outcome Measures / Patients / patient‐reported outcomes / Performance evaluation / Pneumonectomy - methods / Postoperative period / Prospective Studies / Questionnaires / Robotic surgery / Robotic Surgical Procedures - methods / Robotics / robotic‐assisted lobectomy / Surgeons / Surgical techniques / Thoracic surgery / Thoracic Surgery, Video-Assisted - methods / video‐assisted lobectomy