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2010 Annual Meeting Abstracts

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Does Alvimopan Augment the Short-Term Outcomes of Laparoscopic Segmental Colectomy Apart From an Accelerated Care Pathway?
*Timothy Geiger, Peter Marcello, *Rocco Ricciardi, *Jason Hall, *Thomas Read, Rusin Lawrence, David Schoetz, Patricia Roberts
Lahey Clinic, Burlington, MA

Objective: Alvimopan (a mu-opioid receptor antagonist) accelerates gastrointestinal tract recovery and time to discharge following open bowel surgery. In this study we sought to evaluate the effect of Alvimopan on time to gastrointestinal tract recovery and time to discharge in patients undergoing elective segmental laparoscopic colectomy in the setting of an accelerated postoperative care pathway
Design: Single center, prospective, observational study
Setting: Tertiary care hospital
Patients: 85 patients undergoing laparoscopic segmental colectomy for one of three diagnoses: diverticular disease, unresectable polyp, or colon cancer.
Intervention: 48 patients received Alvimopan while 37 control patients did not. All patients underwent the same accelerated postoperative care pathway.
Main outcome measures: We recorded time to first bowel movement and time to discharge. Mann-Whitney or Chi-square and Fisher’s exact tests were used for continuous and categorical variables, respectively.
Results: There were no significant differences in patient demographics, surgical indications, and procedure performed for the Alvimopan and control groups. However, patients treated with Alvimopan did have significantly higher body mass index (28.7+5.6) as compared to controls (25.8+4.2; p<0.05). Alvimopan treated patients also had an earlier time to first bowel movement (2.9+1.7 days vs. 3.9+1.7 days; p=0.01) and faster time to discharge (4.2+2.3 days vs. 4.9+2.2 days, p=0.02) as compared to controls.
Conclusions: Patients who received Alvimopan had a faster time to gastrointestinal tract recovery and time to discharge following elective segmental laparoscopic colectomy as compared to controls. Alvimopan appears to augment the short-term outcomes of laparoscopic segmental colectomy apart from an accelerated care pathway.

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