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PleurX导管治疗恶性腹水的安全性和有效性。

Safety and efficacy of the PleurX catheter for the treatment of malignant ascites.

作者信息

Narayanan Govindarajan, Pezeshkmehr Amir, Venkat Shree, Guerrero Gabriella, Barbery Katuzka

机构信息

Department of Radiology, Vascular and Interventional Radiology, University of Miami , Miller School of Medicine, Miami, Florida.

出版信息

J Palliat Med. 2014 Aug;17(8):906-12. doi: 10.1089/jpm.2013.0427. Epub 2014 Jun 2.

Abstract

BACKGROUND

Malignant ascites is a common complication seen in association with various types of neoplastic processes. Due to high recurrence rates, patients may require multiple paracenteses, which have associated complications such as increased risk of bleeding, infection, pain, and volume and electrolyte depletion.

OBJECTIVE

This study evaluated the management of malignant ascites by placement of the PleurX® tunneled catheter system at a single center.

METHODS

This was a retrospective study of 38 patients who underwent PleurX catheter placement for refractory malignant ascites between February 2006 and March 2012 at our institution. Pretreatment characteristics and outcome measures were reported using descriptive statistics.

RESULTS

The population included 21 males and 17 females with a mean age of 60.6 years (range, 36-79 years) diagnosed with metastatic disease from a variety of primary malignancies, the most common of which was pancreatic cancer (10 patients). In 84% of patients (32/38) who were not lost to follow-up, mean survival time was 40.7 days (range 4-434 days). Technical success rate of catheter placement was 100%.

CONCLUSIONS

The PleurX catheter can be used to manage malignant ascites in severely ill patients with metastatic cancer, with a high rate of procedural success and a low incidence of potentially serious adverse events, infections, or catheter-related complications.

摘要

背景

恶性腹水是与多种肿瘤性疾病相关的常见并发症。由于复发率高,患者可能需要多次进行腹腔穿刺术,而这会带来诸如出血风险增加、感染、疼痛以及容量和电解质耗竭等相关并发症。

目的

本研究评估了在单一中心使用PleurX®隧道式导管系统治疗恶性腹水的效果。

方法

这是一项回顾性研究,研究对象为2006年2月至2012年3月期间在我院因难治性恶性腹水接受PleurX导管置入术的38例患者。采用描述性统计报告预处理特征和结局指标。

结果

研究人群包括21名男性和17名女性,平均年龄60.6岁(范围36 - 79岁),诊断为来自多种原发性恶性肿瘤的转移性疾病,其中最常见的是胰腺癌(10例患者)。在84%(32/38)未失访的患者中,平均生存时间为40.7天(范围4 - 434天)。导管置入的技术成功率为100%。

结论

PleurX导管可用于治疗患有转移性癌症的重症患者的恶性腹水,手术成功率高,潜在严重不良事件、感染或导管相关并发症的发生率低。

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