Alvimopan for Enhanced Gastrointestinal Recovery after Cytoreductive Surgery and Hyperthermic Intraperitoneal...

Area of Science:

• Surgical Oncology
• Gastroenterology
• Pharmacology

Background:

• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a complex procedure for peritoneal metastases.
• This surgery often leads to prolonged recovery, including delayed return of bowel function and extended hospital stays.
• Postoperative ileus is a significant complication following CRS-HIPEC.

Purpose of the Study:

• To evaluate the efficacy of alvimopan in accelerating the return of bowel function in patients undergoing CRS-HIPEC.
• To assess the impact of alvimopan on key recovery metrics such as time to solid food tolerance and first bowel movement.

Main Methods:

• A double-blind, randomized, placebo-controlled trial involving 62 patients undergoing CRS-HIPEC.
• Patients received either alvimopan or a placebo preoperatively and for seven days postoperatively.
• Primary endpoint was time to tolerance of solid food and first bowel movement (GI-2).

Main Results:

• Alvimopan significantly reduced the median time to GI-2 (117 hours vs. 152 hours, p=0.04).
• Time to first bowel movement was also significantly shorter in the alvimopan group (67 hours vs. 89 hours, p=0.02).
• No significant differences were observed in adverse event rates or prolonged ileus between groups.

Conclusions:

• Perioperative alvimopan is effective in accelerating bowel function recovery after CRS-HIPEC.
• Alvimopan is well-tolerated in this patient population.
• The use of alvimopan may improve postoperative recovery timelines for patients undergoing CRS-HIPEC.