TITLE:
A Preliminary Investigation: Alvimopan Use to Prevent Post-Operative Ileus after Radical Cystectomy with Urinary Diversion
AUTHORS:
Benjamin F. Katz, Geoffrey S. Gaunay, Basir U. Tareen, Erik T. Goluboff
KEYWORDS:
Cystectomy; Urinary Diversion; Alvimopan; Ileus
JOURNAL NAME:
Open Journal of Urology,
Vol.3 No.7,
November
13,
2013
ABSTRACT:
Background: Postoperative ileus (POI) is a common and frustrating patient
complication after a urinary diversion by using a segment of bowel. Alvimopan
is an oral selective antagonist to the peripheral μ-opioid receptor. Our study investigates the effect of alvimopan
on POI in patients undergoing radical cystectomy. There are no documented
studies on alvimopan’s efficacy in urologic surgery literature. Methods: Approval
from the Institutional Review Board was obtained to conduct a retrospective
review of patients’ records from August 2009 until August 2011. The study included
sixteen patients who had undergone radical cystectomy with ileal diversion. Exclusion
criteria included patients with chronic opioid use, previous colostomy or
ileostomy, or significant comorbidities which could cause increased postoperative
complications. Statistical analysis was performed to examine the association of
alvimopan use with decreased time to dietary advancement and decreased length
of hospital stay. Results: The alvimopan group advanced their diet
more than 24 hours earlier in comparison with the alvimopan
naive group (P Interpretation: To our knowledge we report one of the first uses of alvimopan in
reducing POI in the urological surgery literature. Our novel experience with
using this drug is encouraging. Further research will ultimately determine if
standard use of alvimopan to decrease POI in
radical cystectomy with ileal diversion will be implemented.