Brief ReportsPleurx Tunneled Catheter in the Management of Malignant Ascites
Section snippets
MATERIALS AND METHODS
Ten patients who where managed with optimum medical care and repeated large volume paracentesis for malignancy related ascites were referred for placement of a tunneled Pleurx catheter. There were seven male patients and three female patients whose ages ranged from 43 to 78 years (mean, 61 y). The patients' underlying malignancies were gastrointestinal in seven and breast, lymphoma, and mesothelioma in one each.
The Pleurx catheter is a 15.5-F catheter with 30 side holes along its distal 26 cm.
RESULTS
Eight of the catheters were placed with combined US and fluoroscopic guidance. Two of the catheters were placed with US guidance alone because fluoroscopic guidance was deemed unnecessary in patients with large amounts of free-flowing ascites. No periprocedural complications were identified, specifically, no patients exhibited hypotension. The patients' initial drainage was 1.5–3 L of ascites. The patients initially drained between 0.5Land1Lof fluid per day for the first week and the amount of
DISCUSSION
Malignant ascites is a dreaded complication of metastatic cancers, such as ovarian, colon, gastric, pancreatic, and breast cancers, mesothelioma, and lymphoma. In most series, the mean survival ranges from 2 to 4 months (1, 2). Malignant ascites can be secondary to peritoneal carcinomatosis, lymphangitic carcinomatosis, or massive hepatic metastasis. Patients with peritoneal carcinomatosis have extensive metastatic implants on the peritoneal surfaces. These implants give rise to elevated
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Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications
2016, Clinical Colorectal CancerCitation Excerpt :Smith et al33 found that paracentesis provided palliation in 93% of patients but had a limited duration of effect, with a mean of 10.4 days and with potential risk. Therefore, to minimize repeated paracenteses and frequent hospital visits, permanent drains are frequently used.21,23,34 We observed in our cohort that 36% (n = 64) of patients underwent paracenteses only as the means of managing ascites, with 58% of this subgroup (n = 37) having 1 to 2 paracenteses, and only 14% (n = 9) having ≥ 3 paracenteses.
Management of symptomatic ascites and post-operative lymphocysts with an easy-to-use, patient-controlled, vascular catheter
2015, Gynecologic OncologyCitation Excerpt :Additional procalcitonin evaluation can be implemented as a routine use in clinical practice [18]. In patients with end-stage abdominal carcinomatosis complicated by MA, the Pleurx tunneled catheter provided effective palliation and alleviated the need for repeated percutaneous paracentesis (experience with ten patients) [19]. The safety and effectiveness were confirmed on 28 consecutive patients (32 drain insertions) with refractory MAs.
Palliative treatment of malignant ascites
2014, Medecine PalliativeTunneled Uncuffed Pigtail Drainage Catheter Placement in Patients with Refractory Ascites or Pleural Effusion: A Single-Center Experience
2022, CardioVascular and Interventional RadiologyPrimary palliative care for surgeons: a narrative review and synthesis of core competencies
2022, Annals of Palliative Medicine
From the SCVIR 2000 Annual Meeting.