The quality of life of patients treated with robotic versus traditional surgery: results from an Italian observational multicenter study

OBJECTIVES: to assess the Quality of Life (QoL), focusing on level of pain, of patients submitted to surgical interventions with robotic technique in comparison with traditional approach in the Italian setting. METHODS: The prospective multicentre study analysed the QoL of 699 patients submitted to surgical interventions, enrolled in 8 Italian Hospitals for the period February 2011-May 2014. The specialties were general, thoracic, gynecological surgery performed with open, manual laparoscopic or robotic technique. Patients completed two questionnaires: one related to pain intensity during the hospitalization and one fulfilled at home related to pain intensity and its impact on daily activities, mood, relationship, sleep. Pain was measured using the scale of facial expressions corresponding to the Visual Analog Scale. For each intervention and specialty, linear regression for repeated measure, corrected by length of stay and use of analgesics, were performed to explain level of pain during hospitalization and at home, respectively. RESULTS: Level of pain during hospitalization is significantly (p=0.05) lower in general and gynecological robotic surgery versus the open technique, but not versus laparoscopic, while robotic thoracic surgery presents significant differences with laparoscopic but not with open surgery (p=0.059). Level of pain at home is significantly different for robotic interventions versus open both in general and gynecological surgery; moreover, with respect to laparoscopic interventions, the differences are significant both in gynecological and in thoracic but not in general surgery. CONCLUSIONS: The study gives us insightful knowledge about QoL, focusing on pain, of patients submitted to surgical interventions with robotic technique vs traditional surgery. Further analysis are in progress to combine results on QoL, not only referred to level of pain, with clinical severity and other indicators of clinical efficacy as length of stay, operating time, medical/surgical complications to refine a robust measure of effectiveness useful to perform cost effectiveness analysis.