Peritoneovenous shunt and neoplastic ascites: A 5‐year experience report

Abstract

The cases of 42 patients with malignant ascites treated with a peritoneal venous shunt over a 5-year period are reviewed to establish the incidence of surgical and postsurgical complications. Although the yield of malignant cells found in the peripheral blood was increased after shunting, no new hematogenous metastases were observed after the operation. No evidence of disseminated intravascular coagulation was observed after shunt placement. While the shunt effectively relieved the discomfort due to abdominal distention and respiratory impairment, no restoration of cutaneous hypersensitivity was observed in the nine patients who were anergic prior to surgery. The median survival of patients with breast and gynecological cancer, after surgery, was significantly longer than the survival of patients with primary gastrointestinal neoplasma. In conclusion, peritoneal venous shunt appears to be an effective and safe method to improve the quality of life of patients with malignant ascites.

The New Model of Carcinogenesis: The Cancer Stem Cell Hypothesis

“…Similar findings have being documented in different cancer patients, patients with malignant ascites, breast cancer (Braun et al, 2005, Riethdorf et al, 2008, and liver cancer. In the case of cancer patients with malignant ascites who have implantation of peritoneo as procedure which help alleviate abdominal distention, but also has the unavoidable effect of shunting huge number of tumor cells into systemic circulation, disseminated cancer is a rare event (Campioni et al, 1986, Tarin et al, 1984. A related clinical example is the recognition that viable breast cancer cells have been found in the bone marrow of a large percentage of patients.…”

Management of symptomatic ascites in recurrent ovarian cancer patients using an intra-abdominal semi-permanent catheter

“…Complications have included fluid overload, respiratory compromise, superior vena cava thrombosis or occlusion, infection, pulmonary edema, and pseudo-occlusion due to elevated central venous pressure. [16][17][18][19] A permanent silastic drain has been reported in 17 patients with promising results. 20 The drain was placed under local anesthesia and eliminated the need for paracentesis in all patients studied with minimal complications.…”