Key result
Robot-assisted minimally invasive esophagectomy significantly reduced physical impairments and postoperative pain while improving long-term health-related quality of life compared to open surgery.
Why the study?
Because improvements have led to longer survival after esophagectomies, long-term postoperative health-related quality of life needs evaluation alongside classic morbidity and mortality outcomes.
Does robotic-assisted minimally invasive esophagectomy improve health-related quality of life compared to open transthoracic esophagectomy in patients with esophageal adenocarcinoma?
Cohort (n=41)
No
Does robotic-assisted minimally invasive esophagectomy improve health-related quality of life compared to open transthoracic esophagectomy in patients with esophageal adenocarcinoma?
Robotic-assisted minimally invasive esophagectomy is associated with significantly better short- and long-term health-related quality of life compared to open surgery in patients with esophageal adenocarcinoma.
Answers are grounded in this paper and cite their sources.
Supports better short- and long-term HRQoL after RAMIE versus OTE; leaves open need for RCTs to confirm.
Esophagectomies are among the most invasive surgical procedures that highly influence health-related quality of life (HRQoL). Recent improvements have helped to achieve longer survival. Therefore, long-term postoperative HRQoL needs to be emphasized in addition to classic criterions like morbidity and mortality. We aimed to compare short and long-term HRQoL after open transthoracic esophagectomies (OTEs) and robotic-assisted minimally invasive esophagectomies (RAMIEs) in patients suffering from esophageal adenocarcinoma. Prospectively collected HRQoL-data (from the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-C30 (EORTC QLQ-C30)) were correlated with clinical courses. Only patients suffering from minor postoperative complications (Clavien-Dindo Classification of < 2) after R0 Ivor-Lewis-procedures were included. Age, sex, body mass index (BMI), American Society of Anesthesiologists physical status-score (ASA-score), tumor stage, and perioperative therapy were used for propensity score matching (PSM). Twelve RAMIE and 29 OTE patients met the inclusion criteria. RAMIE patients reported significantly better emotional and social function while suffering from significantly less pain and less physical impairment four months after surgery. The long-term follow up confirmed the results. Long-term postoperative HRQoL and self-perception partly exceeded the levels of the healthy reference population. Minor operative trauma by robotic approaches resulted in significantly reduced physical impairments while improving HRQoL and self-perception, especially in the long-term. However, further long-term results are warranted to confirm this positive trend.
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Mehdorn et al. (2020) conducted a cohort in Esophageal adenocarcinoma (n=41). Robot-assisted minimally invasive esophagectomy (RAMIE) vs. Open transthoracic esophagectomy (OTE) was evaluated on Health-related quality of life (HRQoL) at 4 and 18 months postoperatively. Robot-assisted minimally invasive esophagectomy significantly reduced physical impairments and postoperative pain while improving long-term health-related quality of life compared to open surgery.
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