Impact of the surgical approach on postoperative quality of life

Abstract

We sought to investigate if robotic mitral surgery had a positive impact on postoperative quality of life. Patients who underwent isolated mitral repair or replacement in our institution since 2020 were offered to participate. A previously validated quality-of-life questionnaire (SF-36) was given to the patients at different postoperative timeframes (preoperative, 15 days, 3, 6 months after surgery). Patients were divided in 2 groups depending on the surgical approach (robotic-R; n = 85 or video-assisted thoracotomy-VAT; n = 32). Data are presented as counts (percentages) or median (IQR); comparisons were made using the Chi-square test or Mann-Whitney U test. There were no major preoperative differences in clinical or in any of three 8 items between groups, except for a trend toward better physical role in the R-group. In all 15 days, both groups showed declined in physical role and increase in bodily pain; furthermore, vitality, social function, emotional role, and mental health seemed worse in the VAT-group. Three months after surgery, physical function has improved compared to baseline in the R-group but not the VAT-groups. Physical function recovered, but mostly in R-group and both groups improved in pain levels. Finally, at 6 months, most values had return to baseline levels in both groups, except for global health, which is lower in VAT-group. Despite the study limitations, the robotic approach seems to provide a better postoperative recovery and thus and improved quality of life compared to a video-assisted thoracotomy approach. Further studies are needed to confirm the findings.

Keywords: Minimally invasive surgery; Physical function; Quality of life; Robotic surgery.