Evidence map›Paper›PMID 37130983›Full record

ArticleSurgical endoscopy2023

Alvimopan is associated with favorable outcomes in open and minimally invasive colorectal surgery: a regional database analysis.

Patricia Kaarto, Kristen M Westfall, Kara Brockhaus, Amanda L Paulus, Jeremy Albright, Carole Ramm, Robert K Cleary

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Patricia KaartoDepartment of Pharmacy, St Joseph Mercy Hospital, Ann Arbor, MI, USA.
Kristen M WestfallDepartment of Surgery, St Joseph Mercy Hospital, Ann Arbor, MI, USA.
Kara BrockhausDepartment of Pharmacy, St Joseph Mercy Hospital, Ann Arbor, MI, USA.
Amanda L PaulusMichigan State University School of Medicine, East Lansing, USA.
Jeremy AlbrightBiostatistics and Epidemiology Methods Consulting, BEMC, LLC, Ypsilanti, MI, USA.
Carole RammSt Joseph Mercy Hospital, Ann Arbor, MI, USA.
Robert K ClearyDepartment of Surgery, St Joseph Mercy Hospital, Ann Arbor, MI, USA. Robert.Cleary@trinity-health.org.ORCID http://orcid.org/0000-0001-6375-7156
Trinity Health Ann Arbor Hospital · USMichigan State University · USTrinity Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlvimopan is a µ-opioid receptor antagonist associated with shorter time to gastrointestinal recovery in patients having open colorectal surgery. Data demonstrating the benefit of perioperative alvimopan for the minimally invasive surgical approach are inconsistent. The aim of this study is to determine colorectal surgery groups that benefit from perioperative alvimopan.

methodsThis is a retrospective cohort analysis of colorectal surgery patients who had, and patients who did not have, perioperative alvimopan in the Michigan Surgical Quality Collaborative regional risk-adjusted database from 2018 through 2021. Main outcome measures were postoperative length of hospital stay, time to return of bowel function, and postoperative ileus.

resultsThere were 10,010 patients (30.3% open, 40.5% laparoscopic, 12.7% hand-assist laparoscopic, 43.5% robotic) who met inclusion criteria-4919 received alvimopan in the perioperative period and 5091 did not. When compared to those not receiving alvimopan, unadjusted outcomes showed that the alvimopan group had significantly shorter postoperative length of stay (4.75 days vs 5.5 days, p < 0.001), shorter time to return of bowel function (1.61 days vs 2.01 days, p < 0.001) and less postoperative ileus (5.45% vs 7.94%, p < 0.001). After adjustment, regression models confirmed that alvimopan was associated with an 9.6% reduction in hospital length of stay (p < 0.001), a 14.9% shorter time to return of bowel function (p < 0.001), and a 42.1% reduction in postoperative ileus (p < 0.001). Subgroup analysis showed significant benefit of alvimopan for all three outcomes in patients having the minimally invasive approach.

conclusionsAlvimopan is associated with shorter hospital length of stay, shorter time to return of bowel function, and decreased postoperative ileus when administered to patients undergoing colorectal surgery. Benefit is not limited to the open approach and includes minimally invasive laparoscopic and robotic colorectal procedures.

Indexed as

Colorectal SurgeryDigestive System Surgical ProceduresIleusGastrointestinal AgentsHumansLength of StayPiperidinesPostoperative ComplicationsRetrospective StudiesalvimopanGastrointestinal AgentsPiperidinesAlvimopanColectomyColon and rectalColorectal surgeryIleus colorectalLength of hospital stay

Identifiers

PMID37130983
OpenAlexW4367675700

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.