Quality of life during the implementation of a robot-assisted thoracic surgery program compared to video-assisted thoracic surgery—a retrospective evaluation of 138 patients

Background: Postoperative quality of life (QoL) and pain are important factors to monitor and analyze when implementing a robot-assisted thoracic surgery (RATS) program. The aim of this study was to compare (I) the postoperative QoL and (II) the incidence of post-surgery pain during the RATS implementation program at our center. Methods: This cross-sectional study evaluated the RATS implementation period at our clinic between April 2018 and September 2019. The results recorded here were compared with the corresponding data of patients who underwent video-assisted thoracic surgery (VATS) in our clinic during the same period. All patients were included consecutively and all types of thoracic diseases were considered. Postoperatively, patients were asked to complete a 31-item questionnaire that included the 100-point QoL visual analogue scale (VAS), the QoL EQ-5D-3L index, and questions about individual pain perception. Furthermore, patient characteristics and perioperative details were collected. Results: In total, 138 patients who underwent minimally invasive resections were included in the study (VATS: 48%, RATS: 52%). RATS was mainly used for the resection of mediastinal tumors. Compared to VATS, patients complained of pain less frequently (P=0.07) and the pain was less severe (P=0.07) after RATS. RATS patients reported a higher VAS QoL (mean: 7.7±2.2) than VATS patients (6.9±2.0; P=0.04), and EQ-5D-3L QoL was higher in RATS patients (0.8±0.26) compared to VATS patients (0.71±0.24; P=0.06). A comparison of the EQ-5D-3L dimensions confirmed that RATS patients reported less pain (P=0.03) and improved mobility compared to VATS patients (P=0.01). Conclusions: In our center, the RATS program was implemented safely. In fact, patients had a higher QoL measured using the 100-point VAS and lower pain scores after RATS than after VATS.