Role of peritoneovenous shunt therapy in end-of-life care of refractory malignant ascites cases

• Published in: Nippon Shōkakibyō Gakkai zasshi Vol. 120; no. 12; p. 1003
• Main Authors: Taniura, Takahito, Yamamoto, Tetsu, Inoue, Keisuke, Kishi, Takashi, Ishitobi, Kazunari, Sato, Yoshitoshi, Hidaka, Masaaki
• Format: Journal Article
• Language: Japanese
• Published: Japan 2023
• Subjects: Ascites - etiology; Ascites - surgery; Female; Humans; Peritoneovenous Shunt - adverse effects; Postoperative Complications - etiology; Retrospective Studies; Terminal Care
• ISSN: 0446-6586
• DOI: 10.11405/nisshoshi.120.1003

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.