Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P057: ALVIMOPAN ADMINISTRATION DOES NOT AFFECT LENGTH OF STAY FOLLOWING OPEN RETROMUSCULAR HERNIA REPAIRS
David J Morrell, MD; Justin A Doble, MD; Eric M Pauli, MD; Penn State Health Milton S. Hershey Medical Center
Introduction: Recovery protocols are a point of emphasis following ventral hernia repair (VHR). Alvimopan has been demonstrated to decrease length of stay in colorectal and gynecologic cohorts and is frequently included in VHR recovery protocols. Existing hernia literature does not account for the effect of alvimopan as an individual component of recovery protocols.
Objectives: Describe effect of alvimopan administration on length of stay (LOS) following open retrorectus VHR.
Methods: A retrospective analysis was performed on data prospectively collected between 2012-2020. All patients undergoing open retrormuscular VHR performed by a single surgeon were identified. Parastomal hernia repairs, minimally invasive VHR, and outpatient procedures were excluded. Linear regression was used to model LOS and time to regular diet. Covariates included locoregional analgesia methods, transfascial suture mesh fixation, modified ventral hernia working group (mVHWG) grade, and 30-day complications.
Results: 217 patients met inclusion criteria (52 patients receiving alvimopan). There was a higher proportion of females in the alvimopan group (65.4% versus 49.7%, p = 0.0480). Otherwise, there were no differences in demographics, comorbidities, mVHWG, or hernia area. The alvimopan group used less morphine milligram equivalents per 24 hours on average (94.0 versus 142.2, p=0.0196). There were no differences in 30-day outcomes (surgical site infection, surgical site occurrence, readmission, reoperation, complications). On univariate analysis, length of stay was significantly shorter in the alvimopan group (3.9 versus 5.6 days, p<0.0001) as was time to regular diet (2.9 versus 4.0 days, p<0.0001). However, after controlling for covariates, alvimopan did not significantly decrease time to regular diet (0.1-day decrease, p=0.8400) or LOS (0.7-day decrease, p=0.1456).
Conclusion: Alvimopan administration appears to not affect LOS following open retrorectus VHR. Administration of alvimopan in VHR should be evaluated with controlled trials before utilization in VHR recovery protocols.
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