TY  - JOUR
A1  - Krimphove, Marieke Johanna
A1  - Reese, Stephen W.
A1  - Chen, Xi
A1  - Marchese, Maya
A1  - Pucheril, Daniel
A1  - Cone, Eugene
A1  - Chou, Wesley
A1  - Tully, Karl Heinrich
A1  - Kibel, Adam S.
A1  - Urman, Richard D.
A1  - Chang, Steven L.
A1  - Kluth, Luis A.
A1  - Dasgupta, Prokar
A1  - Trinh, Quoc-Dien
T1  - Recovery from minimally invasive vs. open surgery in kidney cancer patients: opioid use and workplace absenteeism
T2  - Investigative and clinical urology
N2  - 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.
KW  - Absenteeism
KW  - Kidney neoplasm
KW  - Minimally invasive surgical procedures
KW  - Nephrectomy
KW  - Opioids
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/57698
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-576982
SN  - 2466-054X
SN  - 2466-0493
VL  - 62.2021
IS  - 1
SP  - 56
EP  - 64
PB  - The Korean Urological Association
CY  - Seoul
ER  -