Tomiyama Koji, Takahashi Mina, Fujii Tetsuya, Kunisue Hironori, Kanaya Yoshiaki, Maruyama Shuitirou, Yokoyama Nobuji, Nakao Atsunori, Soda Mitsuhiro, Shimizu Nobuyoshi
Department of Cancer and Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Okayama-city, Okayama, Japan.
Anticancer Res. 2006 May-Jun;26(3B):2393-5.
Intractable ascites secondary to malignant disease deteriorates the patients' quality of life.
Thirty-three patients, who had undergone Denver peritoneovenous shunt for the treatment of ascites associated with malignant tumor from May 1998 to February 2004, were retrospectively analyzed.
Post-operative complications had occurred in twelve patients, including disseminated intravascular coagulation in eight, pulmonary edema in three and wound hematoma in one. The patients' post-operative mean survival was 54.5 days with occlusion occurring in four (12.1%). Comparison of pre- and postoperative values showed a significant decrease of body weight and abdominal girth. Thirteen patients needed no post-operative therapy for ascites, whereas 17 patients could tentatively remain at home or be discharged.
The Denver shunt for malignant ascites is useful in improving quality of life, if indications are selected properly. Further experience and discussion are necessary to establish the patient selection criteria.
恶性疾病继发的顽固性腹水会降低患者的生活质量。
回顾性分析了1998年5月至2004年2月期间因恶性肿瘤相关性腹水接受丹佛腹腔静脉分流术治疗的33例患者。
12例患者出现术后并发症,其中8例发生弥散性血管内凝血,3例发生肺水肿,1例发生伤口血肿。患者术后平均生存期为54.5天,4例(12.1%)出现分流管堵塞。术前和术后各项指标比较显示,体重和腹围显著下降。13例患者术后无需进行腹水治疗,17例患者可暂时居家或出院。
如果正确选择适应证,丹佛分流术治疗恶性腹水有助于提高生活质量。需要进一步的经验和讨论来确立患者选择标准。