Comparison of early postoperative patient-reported outcomes after multiportal robotic-assisted thoracoscopic surgery and uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer.

INTRODUCTION: We aimed to compare early postoperative patient-reported outcomes between multiportal robotic-assisted thoracoscopic surgery (M-RATS) and uniportal video-assisted thoracoscopic surgery (U-VATS) for non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Symptom severity and functional status were measured using the Perioperative Symptom Assessment for Lung Surgery at pre-surgery, during postoperative hospitalisation, and within 4 weeks of discharge. A propensity score-matched (PSM) analysis of patients with NSCLC who were treated with M-RATS and U-VATS was performed. The symptom severity and daily functional status presented as proportion of moderate-to-severe scores on a 0-10-point scale, were compared using a generalised estimation equation model. RESULTS: We enrolled 762 patients with NSCLC from a prospective cohort (CN-PRO-Lung 3), including 151 and 611 who underwent M-RATS and U-VATS, respectively, before PSM analysis. After 1:1 PSM, two groups of 148 patients each were created. Pain severity (P = 0.019) and activity limitation (P = 0.001) during hospitalisation were higher in the M-RATS group. However, no significant differences existed post-discharge in pain (P = 0.383), cough (P = 0.677), shortness of breath (P = 0.526), disturbed sleep (P = 0.525), drowsiness (P = 0.304), fatigue (P = 0.153), distress (P = 0.893), walking difficulty (P = 0.242), or activity limitation (P = 0.513). M-RATS caused less intraoperative blood loss (P = 0.013), more stations of dissected lymph nodes (P = 0.001), more numbers of dissected lymph nodes (P = 0.001), and less tube drainage on the first postoperative day (P = 0.003) than U-VATS. CONCLUSION: M-RATS and U-VATS achieved comparable symptom burden and functional impairment after discharge. However, compared to U-VATS, M-RATS was associated with more severe pain and activity limitation in the short postoperative period. TRIAL REGISTRATION NUMBER: ChiCTR2000033016.

Patient's experiences of coughing after lung cancer surgery: A multicenter qualitative study.

PURPOSE: Cough is one of the most common symptoms after lung cancer surgery, which seriously affects the quality of life. Little research has been conducted on patient's experiences of cough following lung surgery. This study aimed to elucidate the experience of coughing after lung cancer surgery from the patient's perspective regarding symptoms and their impacts on daily life, as well as triggers and dealing strategies. METHODS: Between June 2023 and July 2023, we conducted semi-structured interviews with patients from outpatient clinics of two hospitals who were pathologically diagnosed with lung cancer and experienced cough after surgery through convenience sampling. The interview recordings were transcribed and analyzed by two researchers. The traditional content analysis and thematic analysis were used to identify the common codes, subthemes, and themes. RESULTS: A total of 28 participants were interviewed. The mean age of the participants was 55.21 years (range: 36-75 years), and 21 participants were female. Most patients (75%) were interviewed within 6 months of surgery. We identified five themes (accompanying symptoms, incentives, effects, solution, and information sources) and 12 subthemes (local symptoms, systemic symptoms, personal factors, external factors, emotion, relationship with others, reduced quality of life, medical measures, nonmedical measures, no measures, relatives and friends, and the Internet). Patients with lung cancer may experience various cough symptoms after surgery, which a variety of internal and external factors can trigger. The coughing imposes a double burden on the physical and psychological due to the negative emotions it provokes. CONCLUSION: We generated a concept framework of cough after lung cancer surgery, providing a basis for further development of measurement tools from the patients' perspective. The lack of knowledge related to coughing highlights the need for adequate and timely health education and professional medical care.