Recovery from minimally invasive vs. open surgery in kidney cancer patients: Opioid use and workplace absenteeism.
Investig Clin Urol
; 62(1): 56-64, 2021 01.
Article
em En
| MEDLINE
| ID: mdl-33314804
ABSTRACT
PURPOSE:
Does surgical approach (minimally invasive vs. open) and type (radical vs. partial nephrectomy) affects opioid use and workplace absenteeism. MATERIALS ANDMETHODS:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Convalescença
/
Retorno ao Trabalho
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Analgésicos Opioides
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Neoplasias Renais
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Nefrectomia
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Investig Clin Urol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos