Value of implantable peritoneal ports in managing recurrent malignant ascites

Ghaffar, Maha K. Abdel; Hassan, Mostafa Kamal; Ibrahim, Mohamed

doi:10.1016/j.ejrnm.2014.02.001

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…Thirty-nine (97.5%) patients were treated successfully without catheter manipulation, or antibiotic therapy, and showed complete relief of symptoms and good compliance until death. Avoidance of repeated PC was satisfactory to patients and clinicians 30. Subcutaneous tumor growth was observed along the tunneled catheter in two patients, 4 and 6 months after placement.…”

Section: Resultsmentioning

confidence: 74%

“…Avoidance of repeated PC and repeated admission to hospital was satisfactory to patients and clinicians after placement of PPP30 or PVS 6. In a series of 17 patients who underwent insertion of a peritoneal drain (published in 1990), all reported satisfaction with the drain and felt that their lifestyle was significantly improved by the device 34.…”

Section: Resultsmentioning

confidence: 92%

“…Insertion of TPC, PPP, or PVS involves many medical resources 5–7,25,30,37. For patients with EOC, a PC to dryness can be safely performed as an outpatient, but takes 6–8 h 18.…”

Section: Discussionmentioning

confidence: 99%

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Drainage of malignant ascites: patient selection and perspectives

Stukan¹

2017

CMAR

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Malignant ascites (MA) is a sign of advanced cancer and poor prognosis. MA can result in impairment in quality of life (QOL) and significant symptoms. As a supportive treatment, ascites can be drained by paracentesis (PC), percutaneously implanted catheters (tunneled, untunneled, central venous catheters), or peritoneal ports, or peritoneovenous shunts. The aim of this study was to evaluate the effectiveness, safety, and patient-reported outcomes (PRO) of different drainage methods for the management of MA. A systematic review of the literature was performed, and 32 original articles met the inclusion criteria. Patients selected for permanent drain insertion demonstrated symptoms related to MA and had undergone repeated PC. The primary focus of the reviewed articles was procedural safety issues. The rate of technical success of drainage device installation was 100%. Most patients experienced improvements in symptom control after ascites drainage. When analyzed together, 19.7% (255/1297) of patients experienced any complication and 6.2% (81/1297) experienced serious adverse events during MA drainage. Complications were reported for every drainage method; however, the least occurred after PC or central venous catheter, while the most serious occurred after peritoneovenous shunts. Adverse events were as follows: catheter obstruction: 4.4%, infection: 4.1%, leakage: 3.5%, catheter dislodgment: 2.3%, hypotension: 0.6%, injuries during device insertion: 0.6%, renal impairment: 0.5%, electrolyte imbalance: 0.2%, other: 3.6%. PRO and QOL endpoints were available for 12 studies. When PRO were measured using an interview, a significant improvement in symptom control and QOL was reported in almost all patients. Once standardized questionnaires were used, improvements in symptomatic scores and role functioning were observed. Deterioration was observed in cognitive and emotional subscales. MA drainage is a safe and effective method to control symptoms associated with ascites, and should be perceived as a supportive care, that can be applied for those who need it at any time of their cancer trajectory. Patient selection should be performed using a thorough assessment of symptoms and QOL, and should not be delayed.

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Section: Resultsmentioning

confidence: 74%

Section: Resultsmentioning

confidence: 92%

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Drainage of malignant ascites: patient selection and perspectives

Stukan¹

2017

CMAR

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“…Compared to other studies, our ports had a substantially shorter duration of port patency (median: 26.5 days), compared to a mean or median port patency duration of nearly 50 days or more. Two studies had median port patency duration of more than 250 days . In our study, 20 patients’ ports remained in situ until death and the duration of port patency was determined by the patients’ survival times.…”

Section: Discussionmentioning

confidence: 95%

“…The first peritoneal port for drainage of ascites was reported by Sabatelli et al . Six other studies of patients with ports for malignant or refractory ascites have since been reported . Table summarises the findings from each study.…”

Section: Discussionmentioning

confidence: 99%

Permanent peritoneal ports for the management of recurrent malignant ascites: a retrospective review of safety and efficacy

Chen

Wong

Hawkins

et al. 2018

Internal Medicine Journal

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Large volume paracentesis is effective in relieving the symptoms of malignant ascites, but frequent procedures are often required. Permanent peritoneal ports are an alternative to repeated procedures. We describe our experience with the use of peritoneal ports in patients at Middlemore Hospital (Auckland, New Zealand) who had a port inserted for the drainage of malignant ascites. Twenty‐eight ports were inserted in 26 patients and accessed a total of 257 times with acceptably low rates of complications including cellulitis, peritonitis and wound dehiscence.

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