Management of Malignant Ascites by Indwelling Tunnelled Catheters in Indian Setup: A Case Series

Malignant Ascites (MA) poses significant symptom burden in patients with peritoneal malignancies at the end of life. Various treatment options are available and Indwelling Tunneled Catheters (ITC) have the advantage of increased patient comfort being soft on abdomen, less painful, easy to tap fluid, and less chances of infection etc. A total of 5 patients underwent insertion of ITC after proper counseling and assessment. Insertion was done in operation theatre under combined ultrasonogram and fluoroscopy guidance. Results: 4 out of 5 patients had favorable outcomes in terms of symptom free days spent at home at end of life. ITC’s are a suitable option to manage symptoms in patients with terminal malignant ascites. Careful patient selection and proper education of the caregivers will increase the success rates of procedures.

[1]  Poornachand Anne,et al.  Innovative Method to Deal with Pericatheter Leak in Home-based Management of Malignant Ascites , 2020, Indian Journal of Palliative Care.

[2]  A. Kaya,et al.  Tunneled Peritoneal Catheter Placement in Palliation of Malignant Ascites: A Study with Two Different Types of Catheters , 2019, BioMed research international.

[3]  S. Bhatnagar,et al.  Central Venous Catheter as Peritoneal Indwelling Catheter for the Management of Recurrent Malignant Ascites: A Case Series , 2019, Indian journal of palliative care.

[4]  I. Vergote,et al.  Tenckhoff tunneled peritoneal catheter placement in the palliative treatment of malignant ascites: technical results and overall clinical outcome , 2016, Radiology and oncology.

[5]  M. Meier,et al.  Malignant ascites in patients with terminal cancer is effectively treated with permanent peritoneal catheter , 2015, Acta radiologica open.

[6]  G. Narayanan,et al.  Safety and efficacy of the PleurX catheter for the treatment of malignant ascites. , 2014, Journal of palliative medicine.

[7]  Y. C. Lee,et al.  Advantages of indwelling pleural catheters for management of malignant pleural effusions , 2013, Current Respiratory Care Reports.

[8]  A. Razack,et al.  PleurX drain use in the management of malignant ascites: safety, complications, long-term patency and factors predictive of success. , 2012, The British journal of radiology.

[9]  T. Miner,et al.  Malignant ascites: A review of prognostic factors, pathophysiology and therapeutic measures. , 2012, World journal of gastrointestinal surgery.

[10]  E. Prommer,et al.  Palliative treatment of malignant ascites: profile of catumaxomab , 2010, Biologics : targets & therapy.

[11]  G. Becker,et al.  Malignant ascites: systematic review and guideline for treatment. , 2006, European journal of cancer.

[12]  F. Orsi,et al.  Percutaneous peritoneovenous shunt positioning: technique and preliminary results , 2002, European Radiology.

[13]  R. Weissleder,et al.  Tunneled peritoneal catheter placement under sonographic and fluoroscopic guidance in the palliative treatment of malignant ascites. , 2001, AJR. American journal of roentgenology.

[14]  I. Hawkins,et al.  Permanent indwelling peritoneal access device for the management of malignant ascites , 1994, CardioVascular and Interventional Radiology.