Riassunto analitico
Introduction: thanks to modern technologies and treatments survival and oncologic outcomes of liver resection have improved. For that reason, the impact of surgery on quality of life (QoL) is becoming of increasing interest. In this setting robotic surgery may play an innovative role in reducing QoL burden in surgery patients.
Methods: in this study, we compared the answers to the SF-36 survey, of 179 patients who underwent robotic liver resection (RLR) vs 101 open liver resection (OLR) patients. The resections were performed between 2014 and 2022 in the AOU of Modena. The questionnaires were telephonically submitted to the patients between January 2023 and March 2024 in order to assess the long-term effects on QoL. Furthermore, the overall survival, recurrency rate, 90-day Comprehensive Complication Index (CCI), length of stay, and readmission at 30-days were confronted. The indications for the resections were multiple including 238 (85%) malignancies and 37 benign lesions (13%). The mean age of the two groups respectively were 62,6 (range: 23,7-86,1 years) years for robotic and 61,0 (range: 20,5-83,4 years) years for open.
Results: short-term outcomes such as length of stay and readmission at 30-day better performed in the RLR group. The mean 90-day CCI values respectively were 14,30 (SD ±17,16) in the robotic group and 26,66 (SD ±25,16) in the open group. Overall survival at the time of the survey fulfillment was of 219 (78%) patients, divided into 155 (87%) robotic and 64 (63%) open patients. The recurrency rate of patients resected for malignancies was of 64 cases (46 still alive) in robotic patients and 38 (22 still alive) in open patients, in 42 cases (15 robotic and 27 open) the information couldn’t be found. The total number of recurrent cancers in both groups reached 43%. The QoL analysis revealed four statistically significant differences: general health, vitality, social functioning, and emotional well-being were improved in the RLR compared to the OLR.
Conclusions: These findings validate the safety, feasibility, and reduced perioperative burden of RLR compared to OLR outlining a slightly improved overall survival and, a partial improvement in patients’ QoL. Nevertheless, the controversial findings of other domains suggest that this subject needs further investigation to assess a scientifically significant overall QoL improvement.
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