Asemota Nicole, Maraschi Alessandro, Lampridis Savvas, Pilling John, King Juliet, Le Reun Corinne, Bille Andrea
Department of Thoracic Surgery, Guy's Hospital London, Great Maze Pond, London SE1 9RT, UK.
Division of Cancer Studies, King's College London, Guy's Hospital London, Great Maze Pond, London SE1 9RT, UK.
J Clin Med. 2023 Sep 27;12(19):6230. doi: 10.3390/jcm12196230.
Post-operative quality of life (QOL) has become crucial in choosing operative approaches in thoracic surgery. However, compared to VATS and thoracotomy, QOL results post-RATS are limited. We compared QOL before and after RATS and between RATS, VATS, and thoracotomy. We conducted a retrospective review of lung cancer surgical patients from 2015 to 2020. Patients completed validated EORTC QOL questionnaires (QLQ-C30 and QLQ-LC13). Results were analysed using the EORTC Scoring Guide, with statistical analysis. A total of 47 (94%) pre- and post-RATS questionnaires were returned. Forty-two patients underwent anatomical lung resections. In addition, 80% of patients experienced uncomplicated recovery. All global and functional QOL domains improved post-operatively, as did most symptoms (13/19). Only four symptoms worsened, including dyspnoea ( = 0.017), with two symptoms unchanged. Of the 148 returned questionnaires for all approaches (open-22/VATS-79/RATS-47), over 70% showed a high pre-operative performance status. Most patients underwent anatomical lung resection, with only VATS patients requiring conversion (n = 6). Complications were slightly higher in RATS, with one patient requiring re-intubation. RATS patients demonstrated the highest global and functional QOL. Physical QOL was lowest after thoracotomy ( = 0.002). RATS patients reported the fewest symptoms, including dyspnoea ( = 0.046), fatigue ( < 0.001), and pain ( = 0.264). Overall, RATS results in a significantly better post-operative QOL and should be considered the preferred surgical approach for lung cancer patients.
术后生活质量（QOL）在胸外科手术方式的选择中变得至关重要。然而，与电视辅助胸腔镜手术（VATS）和开胸手术相比，机器人辅助胸腔镜手术（RATS）后的生活质量结果有限。我们比较了RATS术前和术后以及RATS、VATS和开胸手术之间的生活质量。我们对2015年至2020年的肺癌手术患者进行了回顾性研究。患者完成了经过验证的欧洲癌症研究与治疗组织（EORTC）生活质量问卷（QLQ - C30和QLQ - LC13）。使用EORTC评分指南进行结果分析，并进行统计学分析。共返回了47份（94%）RATS术前和术后问卷。42例患者接受了解剖性肺切除术。此外，80%的患者恢复过程顺利。所有总体和功能性生活质量领域术后均有所改善，大多数症状（13/19）也是如此。只有四种症状恶化，包括呼吸困难（P = 0.017），两种症状未改变。在所有手术方式返回的148份问卷中（开胸手术 - 22份/VATS - 79份/RATS - 47份），超过70%显示术前功能状态良好。大多数患者接受了解剖性肺切除术，只有VATS患者需要中转手术（n = 6）。RATS组的并发症略高，有1例患者需要再次插管。RATS患者的总体和功能性生活质量最高。开胸手术后身体生活质量最低（P = 0.002）。RATS患者报告的症状最少，包括呼吸困难（P = 0.046）、疲劳（P < 0.001）和疼痛（P = 0.264）。总体而言，RATS术后生活质量明显更好，应被视为肺癌患者的首选手术方式。
