Application of Alvimopan as a Component of Enhanced Recovery After Surgery (ERAS) Protocol for Patients Undergoing Radical Cystectomy and Diversion (C&D)

Introduction Radical cystectomy with urinary diversion (C&D) is performed for patients with muscle-invasive bladder cancer (MIBC) or refractory carcinoma in situ (CIS) C&D patients receive one of several types of diversion depending on their age, comorbidities, functional status, and extent of disease (Figure 1) Post-operative length of stay (LOS) can be prolonged (9-11 days) and 30 day readmission rates and mortality elevated (30% and 1.5%); return of bowel function usually the rate-limiting step to discharge Enhanced Recovery After Surgery (ERAS) protocols utilize pre-, intra-, and postoperative elements in order to improve return of bowel function and decrease LOS Alvimopan is a μ-opioid receptor antagonist commonly included in ERAS, and limits deleterious effects of narcotics on the GI system The goal of this analysis was to determine the effect of Alvimopan on post-operative LOS and 30 day readmission in patients undergoing C&Dhttps://jdc.jefferson.edu/patientsafetyposters/1131/thumbnail.jp