BACKGROUND Postoperative ileus (POI) is a temporary delay of coordinated intestinal peristalsis. Alvimopan, an oral peripherally acting mu-opioid receptor antagonist approved for accelerating gastrointestinal recovery, has never been studied specifically in patients with inflammatory bowel disease (IBD). AIM To investigate the efficacy of alvimopan in preventing POI among IBD patients. METHODS A retrospective chart review was conducted on 246 IBD patients undergoing bowel surgery between 2012 and 2017. Data collected included demographics, IBD subtype, length of stay (LOS), postoperative gastrointestinal symptoms, and administration of alvimopan. The primary outcome was POI; secondary gastrointestinal recovery outcomes were: time to first flatus, time to first bowel movement, time to tolerating a liquid diet, time to tolerating solid food, and LOS. RESULTS When compared with the control group, patients in the alvimopan group had shorter times to tolerating liquids and solids, first flatus, and first bowel movements (p < 0.01). LOS was shorter in the alvimopan group when compared with controls (p < 0.01). The overall incidence of POI was higher in controls than in the alvimopan group (p = 0.07). For laparoscopic surgeries, the incidence of POI was also higher in controls than in the alvimopan group (p < 0.01). On multivariable analysis, alvimopan significantly decreased time to all gastrointestinal recovery endpoints when compared to controls (p < 0.01). CONCLUSIONS Alvimopan is effective in accelerating time to gastrointestinal recovery and reducing POI in IBD patients. While the benefits of alvimopan have been demonstrated previously, this is the first study of the efficacy of alvimopan in IBD patients.

中文翻译：

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Alvimopan预防炎性肠病患者术后肠梗阻。

背景技术术后肠梗阻（POI）是肠蠕动的暂时性延迟。Alvimopan是一种经批准可促进胃肠道康复的口服外周阿片类阿片受体拮抗剂，从未在炎症性肠病（IBD）患者中进行过专门研究。目的研究阿尔维莫潘预防IBD患者POI的疗效。方法对2012年至2017年间246名接受肠手术的IBD患者进行回顾性图表回顾。收集的数据包括人口统计学，IBD亚型，住院时间（LOS），术后胃肠道症状和alvimopan的使用。主要结果是兴趣点。次要胃肠道恢复的结果是：第一次肠胀气的时间，第一次肠蠕动的时间，耐受流质饮食的时间，耐受固体食物的时间，和LOS。结果与对照组相比，阿尔维潘组的患者耐受液体和固体，首次肠胃气胀和初次肠蠕动的时间较短（p <0.01）。与对照组相比，alvimopan组的LOS较短（p <0.01）。对照组中POI的总发生率高于阿尔莫潘组（p = 0.07）。对于腹腔镜手术，对照组的POI发生率也高于alvimopan组（p <0.01）。在多变量分析中，与对照组相比，alvimopan显着减少了到达所有胃肠道恢复终点的时间（p <0.01）。结论Alvimopan可有效缩短胃肠道恢复时间并减少IBD患者的POI。尽管先前已经证明了alvimopan的好处，