REGULAR CONTENT
Final ID
657
Type
Educational Exhibit-Poster Only
Authors
A Mohandas1, M Le1, M Harvill1, J Critchfield1
Institutions
1Detroit Medical Center/ Wayne State University, Detroit, MI
Purpose
Malignant ascites (MA) occurs in as many as 50% of patients with cancer particularly in those with ovarian, colorectal and hepatobiliary tumors. MA is often refractory to sodium restriction and diuretic therapy and significantly deteriorates the quality of life of the patient. Peritoneovenous shunt (PVS) placement offers an alternative to repeated paracentesis and pleurx catheter placement in refractory cases. We conducted a systematic review elucidating the outcomes of Denver PVS placement with the aim of summarizing its role in current practice.
Materials & Methods
The medline and embase databases were searched from inception to June 2016 for papers that evaluated Denver PVS placement for management of refractory malignant ascites. Two reviewers independently reviewed and compiled a final list of relevant articles and extracted data pertaining to outcomes such as technical success, symptom alleviation and complication rate. SPSS software, version 17 (SPSS, Chicago, IL) was used for all analyses.
Results
A total of 8 articles were finalized for data extraction including a total of 262 patients. A technical success rate of 100% was observed across all studies. Symptom alleviation was achieved in 82.4% of the cases. Shunt occlusion was observed in 9.9% of cases with a shunt revision/replacement rate of 5%. The shunt related mortality was 3.4%. Overall complication rate aside from shunt occlusion was 33.2% with disseminated intravascular thrombosis (7.6%), gastrointestinal bleeding (5%) and fever (4.2%) being most common.
Conclusions
Despite difficulty in maintenance of shunt patency and potential for other serious complications, Denver PVS placement is technically straightforward with excellent symptom alleviation rates and remains an attractive option for treatment of malignant refractory ascites. With appropriate patient selection Denver PVS can continue to be considered as a viable alternative in current practice.
Final ID
657
Type
Educational Exhibit-Poster Only
Authors
A Mohandas1, M Le1, M Harvill1, J Critchfield1
Institutions
1Detroit Medical Center/ Wayne State University, Detroit, MI
Purpose
Malignant ascites (MA) occurs in as many as 50% of patients with cancer particularly in those with ovarian, colorectal and hepatobiliary tumors. MA is often refractory to sodium restriction and diuretic therapy and significantly deteriorates the quality of life of the patient. Peritoneovenous shunt (PVS) placement offers an alternative to repeated paracentesis and pleurx catheter placement in refractory cases. We conducted a systematic review elucidating the outcomes of Denver PVS placement with the aim of summarizing its role in current practice.
Materials & Methods
The medline and embase databases were searched from inception to June 2016 for papers that evaluated Denver PVS placement for management of refractory malignant ascites. Two reviewers independently reviewed and compiled a final list of relevant articles and extracted data pertaining to outcomes such as technical success, symptom alleviation and complication rate. SPSS software, version 17 (SPSS, Chicago, IL) was used for all analyses.
Results
A total of 8 articles were finalized for data extraction including a total of 262 patients. A technical success rate of 100% was observed across all studies. Symptom alleviation was achieved in 82.4% of the cases. Shunt occlusion was observed in 9.9% of cases with a shunt revision/replacement rate of 5%. The shunt related mortality was 3.4%. Overall complication rate aside from shunt occlusion was 33.2% with disseminated intravascular thrombosis (7.6%), gastrointestinal bleeding (5%) and fever (4.2%) being most common.
Conclusions
Despite difficulty in maintenance of shunt patency and potential for other serious complications, Denver PVS placement is technically straightforward with excellent symptom alleviation rates and remains an attractive option for treatment of malignant refractory ascites. With appropriate patient selection Denver PVS can continue to be considered as a viable alternative in current practice.