Alvimopan, a novel, peripherally acting mu opioid antagonist: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus.


OBJECTIVE:To demonstrate that alvimopan (6 or 12 mg) accelerates recovery of gastrointestinal (GI) function in patients undergoing laparotomy for bowel resection or radical hysterectomy. SUMMARY BACKGROUND DATA:Postoperative ileus (POI) following laparotomy may increase morbidity and extend hospitalization. Opioids can contribute to the duration of POI. Alvimopan is a novel opioid receptor antagonist in development for the management of POI. METHODS:A total of 510 patients scheduled for bowel resection or radical hysterectomy were randomized (1:1:1) to receive alvimopan 6 mg, alvimopan 12 mg, or placebo orally > or =2 hours before surgery, then twice a day (b.i.d.) until hospital discharge or for up to 7 days. The primary efficacy end point was a composite of time to recovery of upper and lower GI function. An associated secondary end point was time to hospital discharge order written. RESULTS:The modified intent-to-treat population included 469 patients (451 bowel resection and 18 radical hysterectomy patients). Time to recovery of GI function was accelerated for the alvimopan 6 mg (hazard ratio [HR] = 1.28; P < 0.05) and 12 mg (HR = 1.54; P < 0.001) groups with a mean difference of 15 and 22 hours, respectively, compared with placebo. The time to hospital discharge order written was also accelerated in the alvimopan 12 mg group (HR = 1.42; P = 0.003) with a mean difference of 20 hours compared with placebo. The incidence of adverse events was similar among treatment groups. CONCLUSIONS:Alvimopan accelerated GI recovery and time to hospital discharge order written compared with placebo in patients undergoing laparotomy and was well tolerated.


Ann Surg


Annals of surgery


Wolff BG,Michelassi F,Gerkin TM,Techner L,Gabriel K,Du W,Wallin BA,Alvimopan Postoperative Ileus Study Group.




Has Abstract


2004-10-01 00:00:00


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  • Partial versus total portacaval shunt in alcoholic cirrhosis. Results of a prospective, randomized clinical trial.

    abstract:OBJECTIVE:Results of the first prospective randomized clinical trial comparing partial and total portacaval shunt for variceal hemorrhage are reported. SUMMARY BACKGROUND DATA:Total portacaval shunts produce subnormal portal pressures, completely diverting hepatic portal flow. Partial shunts maintain higher pressures ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Sarfeh IJ,Rypins EB

    更新日期:1994-04-01 00:00:00

  • Fetal wound healing. The ontogeny of scar formation in the non-human primate.

    abstract:OBJECTIVE:This study determined how scar formation develops in a non-human primate model of fetal skin repair. SUMMARY BACKGROUND DATA:A transition from healing scarlessly to healing with scar formation characterizes skin repair in rat and sheep fetuses. New knowledge of the regulatory processes occurring in the fetal...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lorenz HP,Whitby DJ,Longaker MT,Adzick NS

    更新日期:1993-04-01 00:00:00

  • The international position on laparoscopic liver surgery: The Louisville Statement, 2008.

    abstract:OBJECTIVE:To summarize the current world position on laparoscopic liver surgery. SUMMARY BACKGROUND DATA:Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been...

    journal_title:Annals of surgery

    pub_type: 共识发展会议,杂志文章,实务指引


    authors: Buell JF,Cherqui D,Geller DA,O'Rourke N,Iannitti D,Dagher I,Koffron AJ,Thomas M,Gayet B,Han HS,Wakabayashi G,Belli G,Kaneko H,Ker CG,Scatton O,Laurent A,Abdalla EK,Chaudhury P,Dutson E,Gamblin C,D'Angelica M,Nag

    更新日期:2009-11-01 00:00:00

  • Cavernous hemangioma of the liver. A single institution report of 16 resections.

    abstract::Over the past 27 years cavernous hemangioma of the liver has been diagnosed in 12 nonoperated patients and in 16 patients who had resection of the lesion at Strong Memorial Hospital. In almost all patients the diagnosis was suggested by an imaging procedure. In the 12 nonoperated patients the average size of the tumor...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Schwartz SI,Husser WC

    更新日期:1987-05-01 00:00:00

  • Patterns of failure in patients with resected stage I and II non-small-cell carcinoma of the lung. The Ludwig Lung Cancer Study Group.

    abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...

    journal_title:Annals of surgery

    pub_type: 杂志文章



    更新日期:1987-01-01 00:00:00

  • Studies on the possible role of thyroid hormone in altered muscle protein turnover during sepsis.

    abstract::Five days after thyroidectomy (Tx) or sham-Tx in young male Sprague-Dawley rats, sepsis was induced by cecal ligation and puncture (CLP). Control animals underwent laparotomy and manipulation of the cecum without ligation or puncture. Sixteen hours after CLP or laparotomy, protein synthesis and degradation were measur...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Hasselgren PO,Chen IW,James JH,Sperling M,Warner BW,Fischer JE

    更新日期:1987-07-01 00:00:00

  • Fifty years' experience with esophageal atresia and tracheoesophageal fistula. Beginning with Cameron Haight's first operation in 1935.

    abstract::Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of a...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Manning PB,Morgan RA,Coran AG,Wesley JR,Polley TZ Jr,Behrendt DM,Kirsh MM,Sloan HE

    更新日期:1986-10-01 00:00:00

  • Effect of resection margins on the recurrence of Crohn's disease in the small bowel. A randomized controlled trial.

    abstract:OBJECTIVE:The authors assess the effect of surgical margin width on recurrence rates after intestinal resection of Crohn's Disease (CD). BACKGROUND:The optimal width of margins when resecting DC of the small bowel is controversial. Most studies have been retrospective and have had conflicting results. METHODS:Patient...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Fazio VW,Marchetti F,Church M,Goldblum JR,Lavery C,Hull TL,Milsom JW,Strong SA,Oakley JR,Secic M

    更新日期:1996-10-01 00:00:00

  • Clinical Decision Analysis and Markov Modeling for Surgeons: An Introductory Overview.

    abstract::This study addresses the use of decision analysis and Markov models to make contemplated decisions for surgical problems. Decision analysis and decision modeling in surgical research are increasing, but many surgeons are unfamiliar with the techniques and are skeptical of the results. The goal of this review is to fam...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Hogendoorn W,Moll FL,Sumpio BE,Hunink MG

    更新日期:2016-08-01 00:00:00

  • Chemical debridement of burns.

    abstract::The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Levenson SM,Kan D,Gruber C,Crowley LV,Lent R,Watford A,Seifter E

    更新日期:1974-10-01 00:00:00

  • Anticatabolic effects of avoiding preoperative fasting by intravenous hypocaloric nutrition: a randomized clinical trial.

    abstract:OBJECTIVE:We tested the hypothesis that the avoidance of preoperative fasting by hypocaloric nutrition attenuates protein catabolism after surgery. SUMMARY BACKGROUND DATA:Prolonged fasting before major abdominal procedures has been demonstrated to accentuate the catabolic response to surgery. METHODS:Twenty-two pati...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Schricker T,Meterissian S,Lattermann R,Adegoke OA,Marliss EB,Mazza L,Eberhart L,Carli F,Nitschman E,Wykes L

    更新日期:2008-12-01 00:00:00

  • Major hepatectomy for the treatment of complex bile duct injury.

    abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Laurent A,Sauvanet A,Farges O,Watrin T,Rivkine E,Belghiti J

    更新日期:2008-07-01 00:00:00

  • Pancreas transplantation. An initial experience with systemic and portal drainage of pancreatic allografts.

    abstract::Pancreas transplantation has evolved dramatically since its introduction in 1966. As new centers for transplantation have developed, the evaluation of complications associated with pancreas transplantation has led to advances in surgical technique. Furthermore, surgical alterations of the pancreas resulting from trans...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Rosenlof LK,Earnhardt RC,Pruett TL,Stevenson WC,Douglas MT,Cornett GC,Hanks JB

    更新日期:1992-06-01 00:00:00

  • Variation in Bariatric Surgery Episode Costs in the Commercially Insured: Implications for Bundled Payments in the Private Sector.

    abstract:OBJECTIVE:To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND:Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kelsall AC,Cassidy R,Ghaferi AA

    更新日期:2018-12-01 00:00:00

  • Surgeon Annual and Cumulative Volumes Predict Early Postoperative Outcomes after Rectal Cancer Resection.

    abstract:OBJECTIVE:To determine if 5-year surgeon cumulative and annual volumes predict improved early postoperative outcomes in patients with rectal cancer. BACKGROUND:Operative experience has been shown to effect surgical outcomes. The differential role of cumulative versus annual volume has not yet been explored for rectal ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Yeo HL,Abelson JS,Mao J,O'Mahoney PR,Milsom JW,Sedrakyan A

    更新日期:2017-01-01 00:00:00

  • Necrotizing pancreatitis: contemporary analysis of 99 consecutive cases.

    abstract:OBJECTIVE:To analyze the impact of a conservative strategy of management in patients with necrotizing pancreatitis, reserving intervention for patients with documented infection or the late complications of organized necrosis. SUMMARY BACKGROUND DATA:The role of surgery in patients with sterile pancreatic necrosis rem...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ashley SW,Perez A,Pierce EA,Brooks DC,Moore FD Jr,Whang EE,Banks PA,Zinner MJ

    更新日期:2001-10-01 00:00:00

  • The role of calcium ions and calcium channel entry blockers in experimental ischemia-reperfusion-induced liver injury.

    abstract::Verapamil administered before treatment, but not after treatment, had a beneficial effect on a 90-minute warm ischemia-reperfusion rat liver injury model. The possible activation of proteases converting the xanthine dehydrogenase to xanthine oxidase, the significant mitochondrial calcium loading during the ischemic pe...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Nauta RJ,Tsimoyiannis E,Uribe M,Walsh DB,Miller D,Butterfield A

    更新日期:1991-02-01 00:00:00

  • Racial/Ethnic Disparities in Perioperative Outcomes of Major Procedures: Results From the National Surgical Quality Improvement Program.

    abstract:OBJECTIVE:To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States. BACKGROUND:Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several type...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ravi P,Sood A,Schmid M,Abdollah F,Sammon JD,Sun M,Klett DE,Varda B,Peabody JO,Menon M,Kibel AS,Nguyen PL,Trinh QD

    更新日期:2015-12-01 00:00:00

  • Comparison of Patient Outcomes of Surgeons Who Are US Versus International Medical Graduates.

    abstract:OBJECTIVE:The aim of this study was to compare patient outcomes between International Medical Graduate (IMG) versus US medical graduate (USMG) surgeons. SUMMARY BACKGROUND DATA:One in 7 surgeons practicing in the US graduated from a foreign medical school. However, it remains unknown whether patient outcomes differ be...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Tsugawa Y,Dimick JB,Jena AB,Maggard-Gibbons M,Blumenthal DM,Gross N,Jha AK

    更新日期:2019-12-10 00:00:00

  • Route and type of nutrition influence mucosal immunity to bacterial pneumonia.

    abstract:OBJECTIVE:To develop a model of established respiratory immunity against Pseudomonas aeruginosa pneumonia and to investigate the effects of route and type of nutrition on this immunity. SUMMARY BACKGROUND DATA:Diet influences the ability of gut-associated lymphoid tissue (GALT) to maintain mucosal immunity. Complex en...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: King BK,Kudsk KA,Li J,Wu Y,Renegar KB

    更新日期:1999-02-01 00:00:00

  • Aspirin and dipyridamole decrease intimal hyperplasia in experimental vein grafts.

    abstract::Release from platelets of a factor mitogenic for smooth muscle cells is a postulated mechanism for the pathogenesis of vascular intimal hyperplasia. In this study the effect of antiplatelet therapy was evaluated. Aspirin (165 mg twice daily) and dipyridamole (25 mg twice daily) were administered to six rhesus monkeys ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: McCann RL,Hagen PO,Fuchs JC

    更新日期:1980-02-01 00:00:00

  • Significantly increased pregnancy rates after laparoscopic restorative proctocolectomy: a cross-sectional study.

    abstract:OBJECTIVE:To assess the impact of a laparoscopic approach on female fecundity in ileoanal pouch surgery. BACKGROUND:Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is associated with tubal factor infertility in female patients. Different studies showed less adhesion formation after laparoscopic co...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Bartels SA,DʼHoore A,Cuesta MA,Bensdorp AJ,Lucas C,Bemelman WA

    更新日期:2012-12-01 00:00:00

  • Appendectomy: a contemporary appraisal.

    abstract:OBJECTIVE:The authors present an accurate and comprehensive snapshot of appendicitis and the practice of appendectomy in the 1990s. METHODS:Appendectomies were performed on 4950 patients in 147 Department of Defense hospitals worldwide over a 12-month period ending January 31, 1993. RESULTS:The median age was 23 year...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Hale DA,Molloy M,Pearl RH,Schutt DC,Jaques DP

    更新日期:1997-03-01 00:00:00

  • Causes of short-term mortality after appendectomy: a population-based case-controlled study.

    abstract:OBJECTIVE:This case control study is a detailed analysis of the causes of death and the risk factors of short-term mortality after appendectomy. SUMMARY BACKGROUND DATA:Although death is a rare event after appendectomy, we found a 7-fold excess mortality after appendectomy overall and a 9-fold excess mortality after n...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Andersson MN,Andersson RE

    更新日期:2011-07-01 00:00:00

  • The Use of Caffeinated Substances by Surgeons for Cognitive Enhancement.

    abstract:OBJECTIVE:To investigate the use of coffee, caffeinated drinks, and caffeine tablets for pharmacological cognitive enhancement (CE) among surgeons. BACKGROUND:Surgeons have demanding workloads, and the resulting fatigue and concentration deficits can lead to medical errors. Some surgeons use substances that promote wa...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Franke AG,Bagusat C,McFarlane C,Tassone-Steiger T,Kneist W,Lieb K

    更新日期:2015-06-01 00:00:00

  • Cumulative Metformin Use and Its Impact on Survival in Gastric Cancer Patients After Gastrectomy.

    abstract:OBJECTIVE:The aim of this study was to evaluate the association between metformin and survival of gastric cancer (GC) patients. BACKGROUND:Metformin has recently received attention as a potential anticancer treatment. However, no study has shown the survival benefit of metformin for GC patients. METHODS:A total of 19...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lee CK,Jung M,Jung I,Heo SJ,Jeong YH,An JY,Kim HI,Cheong JH,Hyung WJ,Noh SH,Kim HS,Rha SY,Chung HC

    更新日期:2016-01-01 00:00:00

  • Hospital length of stay after admission for traumatic injury in Canada: a multicenter cohort study.

    abstract:OBJECTIVE:To describe acute care length of stay (LOS) over all consecutive hospitalizations for the injury and according to level of care [intensive care unit (ICU), intermediate care, general ward], compare observed and expected LOS, and identify predictors of LOS. BACKGROUND:Prolonged LOS has important consequences ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Moore L,Stelfox HT,Turgeon AF,Nathens A,Bourgeois G,Lapointe J,Gagné M,Lavoie A

    更新日期:2014-07-01 00:00:00

  • Insulin treatment improves hepatic morphology and function through modulation of hepatic signals after severe trauma.

    abstract:OBJECTIVE:The purpose of the present study was to determine the effect of insulin therapy on hepatic function, structure, and hepatic mRNA and protein cytokine expression during the hypermetabolic cascade post burn. SUMMARY BACKGROUND DATA:Liver function and morphology are crucial for survival of patients suffering fr...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Klein D,Schubert T,Horch RE,Jauch KW,Jeschke MG

    更新日期:2004-08-01 00:00:00

  • Choice of abdominal operative incision in the obese patient: a study using blood gas measurements.

    abstract::Although many factors may influence the choice of the operative incision, physiologic safety in terms of the degree of postoperative hypoxemia should be considered. No data currently exist to delineate in markedly obese patients the effect of the operative incision on the extent or duration of this hypoxemia. Fifty-f...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Vaughan RW,Wise L

    更新日期:1975-06-01 00:00:00

  • Muscle protein catabolism after severe burn: effects of IGF-1/IGFBP-3 treatment.

    abstract:OBJECTIVE:To determine the effects of recombinant human insulin-like growth factor-1 (IGF-1) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children. SUMMARY BACKGROUND DATA:Severe burns are associated with a persistent hypermetabolic response characterized by h...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Herndon DN,Ramzy PI,DebRoy MA,Zheng M,Ferrando AA,Chinkes DL,Barret JP,Wolfe RR,Wolf SE

    更新日期:1999-05-01 00:00:00