Tunnelled peritoneal catheter placement in the palliative treatment of malignant ascites: technical results and overall clinical outcome

  • Geert Maleux University Hospitals Leuven
  • Inge Indesteege University Hospitals Leuven
  • Annouschka Laenen KU Leuven and Universiteit Hasselt
  • Chris Verslype University Hospitals Leuven
  • Ignace Vergote University Hospitals Leuven

Abstract

Purpose: to assess the technical and clinical outcome ofpercutaneous insertion of tunneled peritoneal catheters in the palliativetreatment of refractory malignant ascites and to determine the safety andfeasibility of intraperitoneal administration of cytotoxic drugs through thetunneled catheter.Materials & methods: consecutive patients palliatively treated with atunneled peritoneal catheter to drain the malignant ascites were identified.Patients’ medical history, procedural and clinical follow-up data, includingcomplications and estimated survival, were reviewed. Additionally, a subanalysis of the patients with widespread ovarian cancer and refractory ascitestreated with or without intraperitoneal administration of cytotoxic drugs wereanalyzed.Results: in all 94 patients it was technically feasible toinsert the peritoneal drainage catheter and to drain a median of 3260 cc (range100 cc – 8500 cc) of malignant ascitic fluid. Post procedural complicationsincluded catheter infection (n=2; 2%), fluid leakage around the entry site(n=4; 4%), catheter occlusion (n=2; 2%), sleeve formation around the cathetertip (n=1; 1%) and accidental loss of the catheter (n=1; 1%). There was noincrease in catheter infection rate in patients treated with or withoutintraperitoneal administration of cytotoxic drugs. Median overall survivalafter catheter insertion is 1.7 months with longer survival in patients withgynecological cancers compared to patients with gastrointestinal cancers(P=0.002). Conclusion: Percutaneous insertion of a tunneled Tenckhoffcatheter for the palliative drainage of malignant ascites and intraperitonealinfusion of cytotoxic drugs is feasible and associated with a very lowcomplication rate, including catheter infection. Patients with widespreadgynecological cancers and refractory malignant ascites might benefit for alonger time of this palliative interventional procedure.

Author Biographies

Geert Maleux, University Hospitals Leuven
Department of Radiology
Inge Indesteege, University Hospitals Leuven
Department of Radiology
Annouschka Laenen, KU Leuven and Universiteit Hasselt
Department of Biostatistics and and Statistical Bioinformatics
Chris Verslype, University Hospitals Leuven
Department of Digestive Oncology
Ignace Vergote, University Hospitals Leuven
Department of Gynaecology
Published
2016-05-10
How to Cite
Maleux, G., Indesteege, I., Laenen, A., Verslype, C., & Vergote, I. (2016). Tunnelled peritoneal catheter placement in the palliative treatment of malignant ascites: technical results and overall clinical outcome. Radiology and Oncology, 50(2). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/2473
Section
Radiology