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Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review.

Publication ,  Journal Article
Fleming, ND; Alvarez-Secord, A; Von Gruenigen, V; Miller, MJ; Abernethy, AP
Published in: J Pain Symptom Manage
September 2009

The safety and efficacy of indwelling intraperitoneal (IP) catheters for the management of refractory malignant ascites is unclear. A systematic literature overview and retrospective chart review of patients with malignant refractory ascites who underwent indwelling IP catheter placement was performed. Standardized literature abstraction and chart review templates were used to ensure that consistent information was collected. Fifteen publications met literature search criteria, representing 221 patients. Tenckhoff (Quinton Instrument Company, Seattle, WA, USA), Pleurex (Denver Biomedical Inc., Golden, CO, USA), and peritoneal catheters were used, along with IP ports. A median 5.9% of cases (range: 2.5%-34%) had documented peritonitis. In the literature, untunneled catheters were most commonly associated with infections. Our chart review added 19 cases from two academic institutions to this literature (median age: 60 years [range: 31-85]; females: 17 [89%]; gynecological malignancies: 14 [73%]). Palliative management before catheter placement included diuretics (n=4 [21%]) and multiple paracenteses (n=11 [58%] had two or more taps [range: 2-8]). Median time from diagnosis to catheter placement was 25 months (range: 1-77). Interventions were: French pigtail catheters (n=16 [84%]), Tenckhoff catheter (n=1 [5%]), and Port-A-Caths (Smith Medical MD, St. Paul, MN, USA) (n=2; 11%). Four (21%) catheters were tunneled. Prophylactic antibiotics were prescribed in six cases (32%). Two cases (11%) had documented infections, seven catheters (37%) became occluded, and two leaked (11%). The median time from catheter until death was 36 days (range: 4-660). Nine patients (47%) were admitted to hospice. In these retrospective studies, indwelling IP catheters appear to be a safe and effective palliative strategy to manage refractory malignant ascites, without overwhelming infection rates.

Duke Scholars

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

September 2009

Volume

38

Issue

3

Start / End Page

341 / 349

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Middle Aged
  • Male
  • Infusions, Parenteral
  • Humans
  • Female
  • Catheters, Indwelling
  • Ascites
  • Anesthesiology
  • Aged, 80 and over
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fleming, N. D., Alvarez-Secord, A., Von Gruenigen, V., Miller, M. J., & Abernethy, A. P. (2009). Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review. J Pain Symptom Manage, 38(3), 341–349. https://doi.org/10.1016/j.jpainsymman.2008.09.008
Fleming, Nicole D., Angeles Alvarez-Secord, Vivian Von Gruenigen, Michael J. Miller, and Amy P. Abernethy. “Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review.J Pain Symptom Manage 38, no. 3 (September 2009): 341–49. https://doi.org/10.1016/j.jpainsymman.2008.09.008.
Fleming ND, Alvarez-Secord A, Von Gruenigen V, Miller MJ, Abernethy AP. Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review. J Pain Symptom Manage. 2009 Sep;38(3):341–9.
Fleming, Nicole D., et al. “Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review.J Pain Symptom Manage, vol. 38, no. 3, Sept. 2009, pp. 341–49. Pubmed, doi:10.1016/j.jpainsymman.2008.09.008.
Fleming ND, Alvarez-Secord A, Von Gruenigen V, Miller MJ, Abernethy AP. Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review. J Pain Symptom Manage. 2009 Sep;38(3):341–349.
Journal cover image

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

September 2009

Volume

38

Issue

3

Start / End Page

341 / 349

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Middle Aged
  • Male
  • Infusions, Parenteral
  • Humans
  • Female
  • Catheters, Indwelling
  • Ascites
  • Anesthesiology
  • Aged, 80 and over