New York, NY — Patients treated with more-invasive surgical techniques for a type of early-stage lung cancer are more likely to become chronic opioid users than patients treated with minimally invasive surgery, highlighting the need for additional research into how pain management after surgery might be a contributing factor to the opioid addiction crisis, according to a study published in JAMA Oncology in September.
Mount Sinai researchers studied 3,900 patients with early non-small-cell lung cancer, the most common type of lung cancer, who either underwent a minimally invasive procedure called video-assisted thoracoscopic surgery (VATS) or traditional open surgery, which is more invasive as it requires spreading the ribs to perform the surgery.
About 71 percent of the patients received opioid prescriptions for post-surgery pain, and 15 percent of them became long-term opioid users after previously not using the drugs. However, the researchers found that patients who received the less-invasive VATS procedure, which involves three small incisions for a video device and surgical instruments, were less likely to fill opioid prescriptions immediately after surgery and in the long term.
“The escalating severity of the opioid epidemic in the United States highlights the need for additional research into how pain management after surgery might be a contributing factor to the opioid addiction,” said Emanuela Taioli, MD, PhD, Director of the Institute for Translational Epidemiology and Professor of Thoracic Surgery and of Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai. “The findings suggest that surgical patients should be treated in the least invasive way to limit pain and the need for opioids after surgery and that minimally-invasive surgical techniques for lung cancer might reduce the need for opioids compared to traditional open surgery.”
This study was funded by a National Cancer Institute grant, P30CA196521.
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The Mount Sinai Health System is New York City’s largest integrated delivery system encompassing seven hospital campuses, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai’s vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The System includes approximately 6,600 primary and specialty care physicians; 10 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report’s “Best Medical Schools”, aligned with a U.S. News & World Report’s “Honor Roll” Hospital, it is ranked as a leading medical school for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report’s “Honor Roll” of top U.S. hospitals; it is one of the nation’s top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 “Best Hospitals” issue. Mount Sinai’s Kravis Children’s Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat, while Mount Sinai Beth Israel, Mount Sinai St. Luke’s and Mount Sinai West are ranked regionally. For more information, visit http://www.mountsinai.org/, or find Mount Sinai on Facebook, Twitter and YouTube.