Prospective cohort study investigating quality of life outcomes following multi-speciality robotic-assisted surgery

Author:

Li Ang1,Stanislaus Christina T.2,Steffens Daniel234,McBride Kate E.234,Leslie Scott34,Thanigasalam Ruban34,Cunich Michelle56789

Affiliation:

1. Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Vitoria, Australia

2. Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia

3. Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia

4. Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia

5. Boden Initiative, Charles Perkins Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia

6. Implementation and Policy, Cardiovascular Initiative, The University of Sydney, Camperdown, New South Wales, Australia

7. Sydney Institute for Women, Children and their Families, Sydney Local Health District, New South Wales, Australia

8. The ANZAC Research Institute, Concord Repatriation General Hospital, Concord, New South Wales, Australia

9. Sydney Health Economics Collaborative, Sydney Local Health District, Camperdown, New South Wales, Australia

Abstract

Introduction: Despite recent evidence on the surgical outcomes of robotic-assisted surgery (RAS), other patient centre outcomes, including quality of life (QOL), are lacking. This study aims to examine changes in QoL trajectories following RAS across different surgical specialities. Patients and Methods: A prospective cohort study was conducted for patients undergoing urologic, cardiothoracic, colorectal or benign gynaecological RAS, between June 2016 and January 2020 at a tertiary referral hospital in Australia. QoL was measured using the 36-item Short-Form Health Survey at pre-operative, 6 weeks and 6 months postoperatively. Physical and mental summary scores and utility index were primary outcomes, and sub-domains were secondary outcomes. Statistical Analysis Used: Mixed-effects linear regressions were used to determine changes in QoL trajectories. Results: Of the 254 patients undergoing RAS, 154 underwent urologic, 36 cardiothoracic, 24 colorectal and 40 benign gynaecological surgery. Overall, the average age was 58.8 years and most patients were male (75.1%). Physical summary scores significantly decreased from pre-operative to 6 weeks’ post-operative in urologic and colorectal RAS; with all surgical specialities at least returning to pre-operative levels within 6 months postoperatively. Mental summary scores consistently increased from pre-operative to 6 months postoperatively for colorectal and gynaecological RAS. Conclusions: RAS contributed to positive changes in QoL, with physical health returning to the pre-operative level and mental health improvements across specialities, in the short term. While degrees of post-operative changes varied amongst specialities, significant improvements demonstrate benefits in RAS.

Publisher

Medknow

Subject

Surgery

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