Recovery from minimally invasive vs. open surgery in kidney cancer patients: Opioid use and workplace absenteeism

Marieke J. Krimphove; Stephen W. Reese; Xi Chen; Maya Marchese; Daniel Pucheril; Eugene Cone; Wesley Chou; Karl H. Tully; Adam S. Kibel; Richard D. Urman; Steven L. Chang; Luis A. Kluth; Prokar Dasgupta; Quoc-Dien Trinh

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저자정보: Marieke J. Krimphove (Harvard Medical School) Stephen W. Reese (Harvard Medical School) Xi Chen (Harvard Medical School) Maya Marchese (Harvard Medical School) Daniel Pucheril (Harvard Medical School) Eugene Cone (Harvard Medical School) Wesley Chou (Harvard Medical School) Karl H. Tully (Harvard Medical School) Adam S. Kibel (Harvard Medical School) Richard D. Urman (Harvard Medical School) Steven L. Chang (Harvard Medical School) Luis A. Kluth (University Hospital Frankfurt) Prokar Dasgupta (King’s College London) Quoc-Dien Trinh (Harvard Medical School)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.62 No.1

발행연도: 2021.1

수록면: 56 - 64 (9page)

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Purpose: Does surgical approach (minimally invasive vs. open) and type (radical vs. partial nephrectomy) affects opioid use and workplace absenteeism. Materials and Methods: Retrospective multivariable regression analysis of 2,646 opioid-naïve patients between 18 and 64 undergoing radical or partial nephrectomy via either a minimally invasive vs. open approach for kidney cancer in the United States between 2012 and 2017 drawn from the IBM Watson Health Database was performed. Outcomes included: (1) opioid use in opioid-naïve patients as measured by opioid prescriptions in the post-operative setting at early, intermediate and prolonged time periods and (2) workplace absenteeism after surgery. Results: Patients undergoing minimally invasive surgery had a lower odds of opioid use in the early and intermediate post-operative periods (early: odds ratio [OR], 0.77; 95% confidence interval [CI], 0.62–0.97; p=0.02, intermediate: OR, 0.60; 95% CI, 0.48–0.75; p<0.01), but not in the prolonged setting (prolonged: OR, 1.00; 95% CI, 0.75–1.34; p=0.98) and had earlier return to work (minimally invasive vs. open: −10.53 days; 95% CI, −17.79 to −3.26; p<0.01). Controlling for approach, patient undergoing partial nephrectomy had lower rates of opioid use across all time periods examined and returned to work earlier than patients undergoing radical nephrectomy (partial vs. radical: −14.41 days; 95% CI, −21.22 to −7.60; p<0.01). Conclusions: Patients undergoing various forms of surgery for kidney cancer had lower rates of peri-operative opioid use, fewer days of workplace absenteeism, but no difference in long-term rates of opioid use in patients undergoing minimally invasive as compared to open surgery.

#Absenteeism #Kidney neoplasm #Minimally invasive surgical procedures #Nephrectomy #Opioids

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