Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
Division of Gastroenterology and Hepatology, Stadtspital Zurich, Zurich, Switzerland.
J Palliat Med. 2022 Jul;25(7):1132-1135. doi: 10.1089/jpm.2021.0506. Epub 2022 Mar 22.
Treatment of refractory ascites remains challenging. We evaluated the safety and efficacy of permanent tunneled peritoneal catheters (PTPC) in this condition. We retrospectively analyzed consecutive patients in palliative situations in a tertiary referral center. Safety parameters, symptom relief, and survival were assessed. Seventy patients were included from February 2012 to January 2021. Ninety percent had ascites due to malignancy, 10% due to end-stage liver disease. The technical procedure was successful in all cases; no deaths occurred. Procedure-related infections were rare and only observed in patients without peri-interventional antibiotics. Most patients experienced symptom relief (76%) and were satisfied with the device (83%). Survival after PTPC was relatively short (median 19 days). PTPC is a safe option for refractory ascites in palliative settings with symptom relief in the majority of patients and should be considered early after onset of ascites. Periprocedural antibiotic prophylaxis may be considered to avoid procedure-related infections.
治疗难治性腹水仍然具有挑战性。我们评估了永久性隧道腹膜导管（PTPC）在这种情况下的安全性和疗效。我们回顾性分析了一家三级转诊中心姑息治疗的连续患者。评估了安全性参数、症状缓解和生存情况。2012 年 2 月至 2021 年 1 月期间共纳入 70 例患者。90%的患者腹水是由恶性肿瘤引起的，10%的患者是由终末期肝病引起的。所有病例的技术操作均成功，无死亡病例。与操作相关的感染很少见，仅发生在无围手术期抗生素的患者中。大多数患者症状缓解（76%），对该设备满意（83%）。PTPC 后的生存时间相对较短（中位时间为 19 天）。PTPC 是姑息治疗中难治性腹水的一种安全选择，大多数患者的症状得到缓解，应在腹水出现后尽早考虑使用。围手术期预防性使用抗生素可能有助于避免与操作相关的感染。
