Alvimopan for post-radical cystectomy ileus: What should we know?

Abstract

Post-operative ileus is a significant issue encountered by numerous patients following radical cystectomy and urinary diversion. It can contribute to prolonged length of hospital stay, increased post-operative morbidity and significant patient discomfort (1). The causes of POI are multifactorial and include manipulation of the gastrointestinal tract due to bowel resection and re-anastomosis, inflammatory mediators, electrolyte imbalances, and use of systemic opioids. Traditional opioids, which bind to mu receptors in the gut, currently play a key role in post-operative pain management after radical cystectomy and can contribute to the development of POI. Prophylactic measures to prevent POI ..