Báo cáo khoa học: Management of malignant pleural effusion and ascites by a triple access multi perforated large diameter catheter port system

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Management of malignant pleural effusion and ascites by a triple access multi perforated large diameter catheter port system
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Báo cáo khoa học: "Management of malignant pleural effusion and ascites by a triple access multi perforated large diameter catheter port system"World Journal of Surgical Oncology BioMed Central Open AccessTechnical innovationsManagement of malignant pleural effusion and ascites by a tripleaccess multi perforated large diameter catheter port systemIhsan Inan*1, Sandra De Sousa†1, Patrick O Myers†1, Brigitte Bouclier†2,Pierre-Yves Dietrich†2, Monica E Hagen†1 and Philippe Morel†1Address: 1Visceral Surgery Division, Department of Surgery, Geneva University Hospital, Rue Micheli-du-Crest 24, CH-1211, Geneva, Switzerlandand 2Oncology Department, Geneva University Hospital, Rue Micheli-du-Crest 24, CH-1211, Geneva, SwitzerlandEmail: Ihsan Inan* - ihsan.inan@hcuge.ch; Sandra De Sousa - sandra.desousa@hcuge.ch; Patrick O Myers - patrick.myers@hcuge.ch;Brigitte Bouclier - brigitte.bouclier@hcuge.ch; Pierre-Yves Dietrich - pierre-yves.dietrich@hcuge.ch; Monica E Hagen - monika.hagen@hcuge.ch;Philippe Morel - philippe.more@hcuge.ch* Corresponding author †Equal contributorsPublished: 18 August 2008 Received: 24 February 2008 Accepted: 18 August 2008World Journal of Surgical Oncology 2008, 6:85 doi:10.1186/1477-7819-6-85This article is available from: http://www.wjso.com/content/6/1/85© 2008 Inan et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Pleural or peritoneal effusions (ascites) are frequent in terminal stage malignancies. Medical management may be hazardous. Methods: A 60-year-old man with metastatic malignant melanoma presented refractory ascites as well as bilateral pleural effusions. After failure of the medical treatment, bilateral pleural aspiration and paracentesis became necessary two to three times a week. A multi perforated 15F silicone catheter connected with a subcutaneous port was implanted in peritoneal and both pleural cavities surgically under general anesthesia. Leakage around the catheter is prevented by subcutaneous tunneling. Surgical technique is described and illustrated in a video. Results: Implanted systems were immediately operational. Follow up period was 41 days. Each port was accessed 10 times and a total of 65200 ml of fluid was drained. By the end of the forth week, pleural effusions diminished, systems were controlled for permeability and chest x-rays confirmed absence of effusion. Conclusion: Implanted port systems for refractory ascites and pleural effusions avoid morbidity and the patients anxiety related to repeated puncture-aspiration. Large catheter diameter allows an easy and fast drainage of large volumes. Compared to chronic indwelling catheters, subcutaneous location of port system allows an entire integration, giving the patient a total liberty in daily life between two sessions of drainage. Drainage can be performed in an outpatient basis as an ambulatory procedure. This patient-friendly technique may be a treatment option in case of failure of other techniques. malignant pleural effusions alone is estimated to 175000BackgroundPleural effusion and ascites are frequent in terminal stage per year [1]. Fluid sequestration significantly compro-malignancies. In the United States, patients affected by mises patients quality of life. Page 1 of 4 (page number not for citation purposes)World Journal of Surgical Oncology 2008, 6:85 http://www.wjso.com/content/6/1/85Almost 75% of all malignant pleural effusions are due to ter, totally implanted port systems into t ...