Ultrasound-guided day-case wide-bore percutaneous mucin aspiration in advanced pseudomyxoma peritonei

Area of Science:

• Oncology
• Gastroenterology
• Interventional Radiology

Background:

• Pseudomyxoma peritonei (PMP) is a rare malignancy characterized by mucinous ascites.
• Advanced PMP often leads to significant patient morbidity due to tumor burden and ascites.
• Current management strategies aim to debulk tumor and manage ascites for symptom relief.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous ultrasound-guided day-case mucin aspiration in patients with advanced PMP.
• To assess the volume of mucin drained and the impact on patient symptoms and abdominal girth.
• To determine the complication rate associated with this minimally invasive procedure.

Main Methods:

• A retrospective study included 16 patients with PMP undergoing 56 aspirations between 2019-2021.
• Procedures were performed under local anesthesia using a wide-bore (28-32 F) suction-enabled catheter.
• Outcomes measured included volume drained, change in abdominal girth, symptom scores (dyspnea, discomfort), and complication grading.

Main Results:

• The mean volume of mucin drained was 7,320 ± 3,000 ml.
• A mean reduction in abdominal girth of 12.2 ± 5 cm was observed post-procedure.
• Only Grade 1 complications were reported, indicating a favorable safety profile.

Conclusions:

• Percutaneous ultrasound-guided day-case mucin aspiration is a safe and effective treatment for advanced PMP.
• The procedure provides significant symptomatic relief and reduces abdominal girth.
• It can be utilized in palliative care or as a bridge to surgery for select patients.