Role of peritoneovenous shunt therapy in end-of-life care of refractory malignant ascites cases
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- TANIURA Takahito
- Department of General Surgery, Matsue Red Cross Hospital Department of Digestive and General Surgery, Shimane University, Faculty of Medicine
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- YAMAMOTO Tetsu
- Department of Digestive and General Surgery, Shimane University, Faculty of Medicine
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- INOUE Keisuke
- Department of Digestive and General Surgery, Shimane University, Faculty of Medicine
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- KISHI Takashi
- Department of Digestive and General Surgery, Shimane University, Faculty of Medicine
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- ISHITOBI Kazunari
- Department of General Surgery, Matsue Red Cross Hospital Department of Digestive and General Surgery, Shimane University, Faculty of Medicine
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- SATO Yoshitoshi
- Department of General Surgery, Matsue Red Cross Hospital
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- HIDAKA Masaaki
- Department of Digestive and General Surgery, Shimane University, Faculty of Medicine
Bibliographic Information
- Other Title
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- 難治性悪性腹水症例に対する腹腔―静脈シャント療法の終末期医療における役割
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Abstract
<p>The short- and long-term outcomes of 34 patients with refractory malignant ascites who underwent peritoneovenous shunt (PVS) therapy were retrospectively reviewed. The primary disease was gastrointestinal cancer in 31 patients and gynecologic cancer in 3 patients. Regarding performance status, 21 patients had Eastern Cooperative Oncology Group Performance Status (PS) 2 and 13 patients were PS 3;thus, many were in a poor general condition. After treatment, abdominal distention disappeared in 79.4% of patients, and appetite improved in 60.9%. The median postoperative survival time was 38 days (range, 1-294 days), and 18 patients (52.9%) were discharged. Disseminated intravascular coagulation with clinical symptoms was observed in 3 patients (8.8%), and heart failure was observed in 7 patients (20.6%). PVS therapy was useful in improving the subjective symptoms of patients with refractory malignant ascites and in enabling them to receive care at home. However, serious postoperative complications are a concern, and appropriate preoperative evaluation is necessary.</p>
Journal
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- Nippon Shokakibyo Gakkai Zasshi
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Nippon Shokakibyo Gakkai Zasshi 120 (12), 1003-1011, 2023-12-10
The Japanese Society of Gastroenterology
