Short-term quality of life outcomes after robotic versus laparoscopic sphincter preserving resections for rectal cancer

Background: The aim of the present study was to compare the quality of life (QoL) of Chinese patients after robotic versus laparoscopic total mesorectal excision (TME) surgery for rectal cancer. Methods: From June 2013 to August 2015, 171 eligible Chinese patients with rectal cancer underwent total mesorectal excisions (TME) in Xijing Hospital, 82 by robot-assisted and 89 by laparoscopic-assisted techniques. Patients completed QLQ-C30 and QLQCR38 questionnaires about validated Chinese versions of the European Organization for Research and Treatment of Cancer before surgery and in the 3rd, 6th and 12th month after surgery. At different time points, QoL scores of the two groups, robotic group and laparoscopic group, were compared. In those questionnaires, higher symptomatic scale scores indicated a higher degree of symptomatics. Higher functional scale scores indicated better function. Results: Many factors were compared in the two groups of patients, including sociodemographic data, types of surgery, tumor staging, and baseline average scores of QoL. Compared to the laparoscopic group, the robotic group had significantly better sexual functioning at 6 months [(15.5 +/- 5.8) vs (10.9 +/- 3.9), P = 0.035], more sexual enjoyment at 3 months [(40.2 +/- 7.5) vs (36.9 +/- 9.6), P = 0.024], and fewer male sexual problems at 3 months [(28.7 +/- 3.6) vs (32.8 +/- 6.9), P = 0.013]. Apart from male sexual enjoyment and sexual problems, compared to the laparoscopic group, although the robotic group showed better global QoL at 3 and 6 months, better physical roles and cognitive functions at 6 months, together with less problems of micturition at 3 to 6 months along with nausea/vomiting and appetite loss and financial difficulties at 6 months were indicated. There was no statistical significance in either functional or symptomatic scales between the two groups from 3 to 12 months after the operation. Furthermore, at one year after the operation, both functional and symptomatic scales between the two groups did not show significant differences. Conclusion: Robotic sphincter preserving resection is a promising alternative for treatment of patients with rectal cancer, offering better QoL and fewer male sexual problems compared with laparoscopic surgery in Chinese patients.