Management of malignant pleural effusion and ascites by a triple access multi perforated large diameter catheter port system.

World Journal of Surgical Oncology
Ihsan InanPhilippe Morel

Abstract

Pleural or peritoneal effusions (ascites) are frequent in terminal stage malignancies. Medical management may be hazardous. A 60-year-old man with metastatic malignant melanoma presented refractory ascites as well as bilateral pleural effusions. After failure of the medical treatment, bilateral pleural aspiration and paracentesis became necessary two to three times a week. A multi perforated 15F silicone catheter connected with a subcutaneous port was implanted in peritoneal and both pleural cavities surgically under general anesthesia. Leakage around the catheter is prevented by subcutaneous tunneling. Surgical technique is described and illustrated in a video. Implanted systems were immediately operational. Follow up period was 41 days. Each port was accessed 10 times and a total of 65'200 ml of fluid was drained. By the end of the forth week, pleural effusions diminished, systems were controlled for permeability and chest x-rays confirmed absence of effusion. Implanted port systems for refractory ascites and pleural effusions avoid morbidity and the patient's anxiety related to repeated puncture-aspiration. Large catheter diameter allows an easy and fast drainage of large volumes. Compared to chronic indwelling catheters, su...Continue Reading

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Citations

Jul 10, 2010·Lung India : Official Organ of Indian Chest Society·K Manu Mohan, K Gowrinath
Mar 3, 2012·Veterinary Surgery : VS·Benjamin A StaigerJonathan F McAnulty
May 2, 2014·The Korean Journal of Thoracic and Cardiovascular Surgery·Massine El HammoumiEl Hassane Kabiri

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