Alvimopan Significantly Reduces Length of Stay and Costs Following Colorectal Resection and Ostomy Reversal Even Within an Enhanced Recovery Protocol

Diseases of the Colon and Rectum
Laura Z HydeRavi P Kiran

Abstract

Alvimopan accelerates GI recovery after colorectal resection. Data on real-world cost-effectiveness have been mixed. This study aimed to evaluate if adding alvimopan to an enhanced recovery pathway reduces length of stay. Patients undergoing colorectal resection or ostomy reversal for the year before and after the introduction of alvimopan were evaluated. This study was conducted at a single academic medical center. Patients undergoing elective colorectal resection (488) or ostomy reversal (148) were included. The primary outcomes measured were length of stay and prolonged length of stay defined as >75th percentile for each procedure. Two hundred eighty-six patients (45%) received alvimopan. Alvimopan and no-alvimopan groups had similar demographics, comorbidities, operative indication, and case mix. In the alvimopan group, more of the colorectal resections were laparoscopic (87% vs 79%, p = 0.015). Length of stay was reduced with alvimopan (6.2 vs 4.9 days, p = 0.003), and this effect persisted when controlling for procedure type, approach, and ASA class (decreased length of stay by 1.0 day, p = 0.014). The alvimopan group had lower risk of prolonged length of stay (14.7% vs 23.1%, p = 0.007) and ileus (10.8% vs 16.2%, p = 0.0...Continue Reading

Associated Clinical Trials

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