Multidimensional Quality of Life After Robotic Versus Laparoscopic Surgery for Rectal Cancer: A Systematic Review and Meta-Analysis

• Published in: World journal of surgery 2023-05, Vol.47 (5), p.1310-1319
• Main Authors: Martins, Russell Seth, Fatimi, Asad Saulat, Mahmud, Omar, Jahangir, Arshia, Mahar, Muhammad Umar, Aamir, Syed Roohan, Khan, Maria, Ahmad, Ali
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Body image; Cancer; Cardiac Surgery; Clinical trials; Cognitive ability; Colorectal cancer; Decision making; General Surgery; Humans; Laparoscopy; Laparoscopy - methods; Medicine; Medicine & Public Health; Meta-analysis; Pain; Patients; Prospective Studies; Quality of Life; Rectal Neoplasms - surgery; Rectum; Retrospective Studies; Robotic surgery; Robotic Surgical Procedures - methods; Scientific Review; Surgery; Systematic review; Thoracic Surgery; Vascular Surgery; Vomiting
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-023-06936-3

Introduction Maximizing patients’ quality of life (QoL) is a central goal in surgical oncology. Currently, both laparoscopic and robotic surgery are viable options in rectal cancer (RC) resections. The aim of this systematic review was to analyze the differences in postoperative QoL between the two operative modalities. Methodology This review was conducted in adherence to the PRISMA guidelines. MEDLINE, Embase, Scopus, and CENTRAL databases were searched for articles comparing QoL in patients undergoing laparoscopic versus robotic surgery for RC. Seven studies were included (two randomized controlled trials, four prospective cohorts, and one retrospective cohort) out of which six reported data suitable for meta-analysis. Global QoL and QoL subdomains, such as physical and social functioning, were meta-analyzed using a random-effects model. Risk of bias was assessed using the ROBINS-I and Cochrane RoB-2 tools. Results Data on 869 patients (440 laparoscopic and 429 robotic surgery) across six studies were meta-analyzed. There was no significant difference in global QoL (Mean Difference:−0.43 [95% Confidence Interval:−3.49–2.62]). Physical functioning was superior after robotic surgery (1.92 [0.97–2.87]). However, nausea/vomiting, pain, and fatigue did not differ between groups. Perception of body image was worse after laparoscopic surgery (−5.06 [−9.05– −1.07]). Other psychosocial subdomains (emotional, cognitive, role, and social functioning) were comparable between groups. Conclusion Laparoscopic and robotic surgery for RC have comparable QoL overall, for both physical and psychological dimensions. Our results may assist the management-related decision-making in surgical treatment of RC.