Does robotic adrenalectomy improve patient quality of life when compared to laparoscopic adrenalectomy?
The purpose of this study was to evaluate and compare perioperative quality of life in patients after laparoscopic versus robotic adrenalectomy. From November 2000 through August 2003, 33 consecutive patients underwent laparoscopic (n = 14) and robotic (n = 19) adrenalectomy. Data were obtained prospectively during management and by patient questionnaire (SF36, State-Trait Anxiety Inventory) preoperatively and postoperatively, at day 4 and at 6 weeks. Physical functioning, role limitations due to physical health problems, and bodily pain (Physical SF36 scores) were decreased at day 4 (p = 0.004) in all patients when compared to preoperative levels; and became similar to preoperative levels after 6 weeks. Patients who underwent robotic adrenalectomy had an increased score at 6 weeks of role limitations due to emotional problems (Mental SF36 score) (p = 0.03). No other significant difference was observed between patients after laparoscopic or robotic adrenalectomy. Although state anxiety was decreased postoperatively at day 4 and at 6 weeks (p = 0.01) in all patients, there was no significant difference between laparoscopic and robotic adrenalectomy. Postoperative pain was similar in both groups but had a tendency to be higher when patients underwent a left adrenalectomy (p = 0.07). Similarly, state anxiety had a tendency to be higher postoperatively at day 4 in patients after left adrenalectomies (p = 0.06). This study provides an evaluation of perioperative quality of life in patients after minimally invasive (laparoscopic and/or robotic) adrenalectomy. We observed no major difference between patients who underwent laparoscopic or robotic adrenalectomy. Thus, patients' perioperative quality of life is not a justifiable parameter on which to base promotion of robotic adrenalectomies.
Department of Visceral, Digestive and Endocrine Surgery, CHU Nancy-Brabois, University of Nancy, Nancy, France. labrunaud@chunancy.fr
Laurent
L
Brunaud
Laurent
L
Bresler
Rasa
R
Zarnegar
Ahmet
A
Ayav
Luc
L
Cormier
Sebastien
S
Tretou
Patrick
P
Boissel
D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D001007:Anxiety; D006305:Health Status Indicators; D006801:Humans; D010535:Laparoscopy; D010149:Postoperative Pain / Q000453:epidemiology; D010673:Pheochromocytoma / Q000601:surgery; D011788:Quality of Life; D012371:Robotics; D012890:Sleep