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Title
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Tenckhoff tunneled peritoneal catheter placement in the palliative treatment of malignant ascites : technical results and overall clinical outcome
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Author
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Abstract
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| Malignant ascites is a manifestation of terminal metastatic disease with a life expectancy ranging from 1 to 4 months; the ascitic fluid production is usually associated with peritoneal tumours, lymphangitic carcinomatosis, lymphatic obstruction, encasement of the portal vein by a tumour causing prehepatic portal hypertension, or a combination of these pathophysiological mechanisms.1–3 Clinically, these patients suffer from abdominal distension, early satiety, shortness of breath, fatigue or gastrointestinal symptoms such as nausea and vomiting. Medical treatment, including diuretics, have little or no effect on malignant fluid accumulation and the standard treatment for these patients was repeated paracentesis, despite the risks of infection, haemorrhage or bowel wall injury and the need for frequent trips to the hospital.4 In the past decade, alternative drainage options intended to avoid repetitive punctures, have been tested and used. These drainage techniques include internal drainage like peritoneo-venous5, peritoneo-gastric6 and peritoneo-cystic7 shunting and external drainage techniques requiring the placement of an indwelling, tunneled peritoneal drainage or portcatheter.2,3,5,8–13 An important disadvantage of external drainage is albumin loss, which may need to be considered in deciding between external drainage and internal shunts. Most of the experience with indwelling drainage catheters has been described with the PleurX catheter; this monocuffed catheter was initially designed for drainage of malignant pleural effusions but it can also be used for drainage of malignant peritoneal fluid.3,9–11 Additionally, if this type of indwelling tunneled catheter is used, it is recommended to use vacuum bottles for adequate drainage. In this study we retrospectively analysed the technical feasibility and safety of the insertion of a Tenckhoff peritoneal tunnelled catheter. Additionally, the overall clinical outcomes in this patient population were analysed and finally we evaluated the feasibility and safety of intraperitoneal chemotherapy delivery through the Tenckhoff catheter in patients with widespread ovarian cancer and refractory ascites using catumaxomab. |
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Language
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English
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Source (journal)
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RADIOLOGY AND ONCOLOGY
Radiology and Oncology
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Publication
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2016
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ISSN
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1318-2099
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DOI
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10.1515/RAON-2016-0002
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Volume/pages
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50
:2
(2016)
, p. 197-203
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Full text (Publisher's DOI)
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Full text (open access)
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