Saiz-Mendiguren R, Gómez-Ayechu M, Noguera J J, García-Lallana A, Marginet C, Cano D, Benito A
Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Radiologia. 2010 Nov-Dec;52(6):541-5. doi: 10.1016/j.rx.2010.06.005. Epub 2010 Sep 21.
The most common treatment in recurrent malignant ascites is generally temporary peritoneal drainage. We present our experience in placing permanent tunneled catheters in a series of patients and analyze the safety and efficacy of the treatment.
We used total aseptic measures in the interventional ultrasonography suite to place permanent tunneled catheters in 10 patients under ultrasonographic guidance and local anesthesia.
The catheters remained patent for a median of 52 days in the nine patients who died. In one of these, the catheter was withdrawn while still patent due to generalized sepsis. At the end of the study, one patient still had a permeable catheter 124 days after placement.
Although the low number of patients in our series precludes generalizations, tunneled peritoneal catheters seem to be a safe and effective minimally invasive treatment for malignant ascites in terminal oncologic patients. This approach facilitates the draining of the ascites at home, obviating the need for repeated hospital visits and punctures and the risks involved therein. Nevertheless, further experience and prospective randomized trials are necessary.
复发性恶性腹水最常见的治疗方法通常是临时腹腔引流。我们介绍了我们在一系列患者中放置永久性隧道式导管的经验,并分析了该治疗方法的安全性和有效性。
我们在介入超声检查室采取完全无菌措施,在超声引导和局部麻醉下为10例患者放置永久性隧道式导管。
9例死亡患者的导管中位通畅时间为52天。其中1例因全身感染,在导管仍通畅时拔除。研究结束时,1例患者在置管124天后导管仍可使用。
尽管我们研究系列中的患者数量较少,无法进行推广,但隧道式腹腔导管似乎是终末期肿瘤患者恶性腹水的一种安全有效的微创治疗方法。这种方法便于在家中引流腹水,避免了反复住院就诊和穿刺及其相关风险。然而,仍需要更多的经验和前瞻性随机试验。