Faught W, Kirkpatrick J R, Krepart G V, Heywood M S, Lotocki R J
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Canada.
J Am Coll Surg. 1995 Apr;180(4):472-4.
Ascites is a common sequela of advanced or recurrent gynecologic malignancies, such as carcinoma of the ovary, fallopian tube, or endometrium. Symptomatic treatment with repeated paracentesis is the initial management after failure of chemotherapy.
This study was done to evaluate the safety and effectiveness of a peritoneovenous shunt (PVS) in the palliation of these patients with recurrent ascites. A retrospective review of 25 patients having a PVS between 1982 and 1992 was performed.
The 25 patients consisted of 21 patients with carcinoma of the ovary, two with primary carcinoma of the peritoneum, one with carcinoma of the endometrium, and one patient with carcinoma of the fallopian tube. The mean weight and abdominal girth decreased after shunt insertion (p < 0.001). Gastrointestinal dysfunction and dyspnea also improved with PVS insertion. There was no change in mean Karnofsky score after placement of a PVS. Two patients died within ten days postoperatively. The median survival period was 80 days and shunt occlusion occurred in four patients.
The insertion of a PVS is effective in relieving refractory malignant ascites in gynecologic malignancies. The impact on quality of life requires further study.
腹水是晚期或复发性妇科恶性肿瘤（如卵巢癌、输卵管癌或子宫内膜癌）的常见后遗症。化疗失败后，反复腹腔穿刺进行对症治疗是初始治疗方法。
本研究旨在评估腹腔静脉分流术（PVS）缓解这些复发性腹水患者症状的安全性和有效性。对1982年至1992年间接受PVS治疗的25例患者进行了回顾性研究。
25例患者中，21例为卵巢癌，2例为原发性腹膜癌，1例为子宫内膜癌，1例为输卵管癌。分流术后平均体重和腹围下降（p < 0.001）。插入PVS后，胃肠功能障碍和呼吸困难也有所改善。放置PVS后，平均卡诺夫斯基评分没有变化。2例患者在术后10天内死亡。中位生存期为80天，4例患者出现分流堵塞。
插入PVS可有效缓解妇科恶性肿瘤难治性恶性腹水。对生活质量的影响需要进一步研究。
