Indwelling Peritoneal Catheters for Managing Malignancy-Associated Ascites

Area of Science:

• Palliative Care
• Gastroenterology
• Oncology

Background:

• Malignancy-associated ascites presents a significant challenge in palliative care, impacting patient quality of life.
• Refractory or rapidly accumulating ascites often requires intervention to manage symptoms and improve patient comfort.

Purpose of the Study:

• To evaluate the safety and efficacy of tunnelled peritoneal catheters for managing malignancy-associated ascites.
• To assess the impact of tunnelled catheter insertion on patient-reported outcomes, including dyspnea and quality of life.

Main Methods:

• Retrospective analysis of a prospectively maintained database of tunnelled peritoneal catheter insertions.
• Inclusion criteria: patients with refractory or new rapidly accumulating malignancy-associated ascites.
• Data collected included procedural success rates, complication rates, catheter dwell times, and quality of life assessments (Dyspnea Index, EORTC QLQ-C30).

Main Results:

• A 100% procedural success rate was achieved in 395 catheter insertions across 386 patients.
• The average catheter dwell time was 66 days, with a 5.57% complication rate (most commonly non-fatal infections).
• Significant improvements were observed in Baseline Dyspnea Index, Transitional Dyspnea Index, and overall quality of life (p < 0.05), including improvements in fatigue, pain, dyspnea, and appetite.

Conclusions:

• Tunnelled peritoneal catheters are a feasible and safe option for managing malignancy-associated ascites in palliative care.
• The procedure is associated with minimal complications and leads to significant improvements in dyspnea and quality of life for patients.
• This intervention provides a valuable tool for symptom management and enhancing the well-being of palliative care patients with ascites.