Sugamoto Yuji, Arasawa Takahiro, Fukunaga Toru, Tasaki Kentaro, Kuboshima Mari, Muto Yasuhide, Sazuka Tetsutaro, Kimura Masayuki, Asai Yo, Fujita Eri, Ota Takumi, Matsubara Hisahiro
Dept. of Surgery, Numazu City Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2059-2061.
This paper reports a case of refractory ascites in a patient with gastric cancer. A peritoneo-venous shunt(PVS)was inserted in the patient, which contributed to extending the duration of home-based care as well as improving the patient's quality of life. The patient was a female in her 70s. She was diagnosed with gastric cancer and underwent total gastrectomy. Five years and 7 months after the surgery, she was diagnosed with peritoneal recurrence. Ascites temporarily decreased following chemotherapy, but gradually worsened thereafter. Since the patient required frequent puncture drainage for the ascites, cell-free concentrated ascites reinfusion therapy(CART)was performed. However, on the day prior to the scheduled second course of CART, marked abdominal distension was observed. Therefore, a PVS was inserted. No PVS-associated complications were observed. Following the insertion of the PVS, the patient's abdominal circumference and body weight markedly improved. Best supportive care(BSC)was provided to the patient as she became weak after undergoing several courses of chemotherapy on an outpatient basis. On the other hand, the PVS was working properly. The patient was able to continue her daily life activities at home. She died from the cancer after 164 days of the PVS insertion.
本文报告了一例胃癌患者难治性腹水的病例。该患者接受了腹腔静脉分流术（PVS），这有助于延长居家护理时间并提高患者的生活质量。患者为一名70多岁的女性。她被诊断为胃癌并接受了全胃切除术。术后5年7个月，她被诊断为腹膜复发。化疗后腹水暂时减少，但此后逐渐恶化。由于患者需要频繁穿刺引流腹水，因此进行了无细胞浓缩腹水回输治疗（CART）。然而，在预定的第二次CART疗程前一天，观察到明显的腹胀。因此，插入了PVS。未观察到与PVS相关的并发症。插入PVS后，患者的腹围和体重明显改善。由于患者在门诊接受了几个疗程的化疗后身体变得虚弱，因此为其提供了最佳支持治疗（BSC）。另一方面，PVS运行正常。患者能够在家中继续进行日常生活活动。在插入PVS 164天后，她死于癌症。
