Outpatient therapeutic paracentesis for malignant ascites: A short report reviewing local practice that supports procedural safety

Background: Malignant ascites causes significant morbidity in patients with cancer. Paracentesis is effective at improving symptoms. However, the methods vary greatly between centres with most procedures performed as inpatients in the United Kingdom and limited evidence supporting the safety of outpatient procedures. Aim: This report reviews the practice and safety of outpatient paracentesis in the DPU. Design: Retrospective review of patients who had undergone day case paracentesis in the Oncology DPU. Setting: Procedures were carried out by experienced clinicians using ultrasonography within the oncology DPU. A total of 523 procedures occurred. Results: Gynaecological cancer was the most common diagnosis. The mean number of procedures per patient was 4.1 and the mean volume of fluid removed was 3.3 l. Baseline observations were recorded in 20 cases and blood tests were not routinely requested. Complications were recorded in 6.7% procedures with an admission rate of 1.1%. Conclusions: This review of clinical practice demonstrates that outpatient paracentesis is relatively safe and effective with a complication rate comparable to inpatient studies, reducing the need for admissions and pressure on local radiology services for the procedure. Areas of future development should consider a patient’s symptom assessment in response to the procedure.