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Jason Reinglas, Kayvan Amjadi, Bill Petrcich, Franco Momoli, Thomas Shaw-Stiffel
Background. Treatment options are limited for patients with refractory cirrhotic ascites (RCA). As such, we assessed the safety and effectiveness of the PleurX catheter for RCA. Methods. A retrospective analysis was performed on all patients with RCA who have undergone insertion of the PleurX catheter between 2007 and 2014 at our clinic. Results. Thirty-three patients with RCA were included in the study; 4 patients were lost to follow-up. All patients were still symptomatic despite bimonthly large volume paracentesis and were not candidates for TIPS or PV shunt...
2016: Canadian Journal of Gastroenterology & Hepatology
Angel Mier Hicks, Joanne Chou, Marinela Capanu, Maeve A Lowery, Kenneth H Yu, Eileen M O'Reilly
BACKGROUND: Ascites develops in a subset of patients with pancreatic adenocarcinoma (PAC) at presentation or as the disease advances. Limited data exist on the prognostic importance of malignant ascites in PAC. Our hypothesis is that this information will provide an understanding of the natural history and facilitate management decisions. METHODS: We conducted a retrospective analysis of 180 patients treated at Memorial Sloan Kettering Cancer Center diagnosed between January 1, 2009 and December 31, 2014, with PAC and with ascites either at presentation or that developed during the disease course...
May 7, 2016: Clinical Colorectal Cancer
Michelle Meier, Frank V Mortensen, Hans Henrik Torp Madsen
BACKGROUND: Malignant ascites is a pathological condition caused by intra- or extra-abdominal disseminated cancer. The object of treatment is palliation. In search of an effective and minimally invasive palliative treatment of malignant ascites placement of a permanent intra peritoneal catheter has been suggested. PURPOSE: To evaluate our experiences with treatment of malignant ascites by implantation of a permanent PleurX catheter. MATERIAL AND METHODS: A retrospective study was conducted, comprising 20 consecutive patients with terminal cancer, who had a permanent PleurX catheter implanted because of malignant ascites in the period from February to November 2014...
July 2015: Acta Radiologica Open
Selina Lam, Stephanie Fraser, Thomas Routledge
No abstract text is available yet for this article.
October 2013: International Journal of Surgery
Bernadette Lee
BACKGROUND: Since 2008, several new doctors have attended the Focused Abdominal UltraSound in Palliative Care course. The course taught the examination protocols for ascites, liver, urinary tract and deep vein thrombosis (DVT). A log book was kept with the scanner. Location YearNew doctors trainedNumber of doctors doing scansNumber of scansNumber of patientswardOPDhomenursing home 2008 63241624000 2009 03151315000 2010 14221620200 2011 47242017250 2012 16402930721 total 12 - 125 94 106 11 7 1 AIMS: The aims were to audit:the frequency of use whether the course examination protocols were followed the impact of having ultrasound whether cleaning of the transducer was recorded Information from the log book and patient records were used to complete the audit...
March 2014: BMJ Supportive & Palliative Care
John Adams, Joanne Auger, Deborah Schiff
Malignant effusions may cause significant morbidity and mortality for cancer patients. Indwelling tunneled PleurX® catheter placement for intermittent drainage of malignant effusions has been shown to be efficacious in adults but has not been studied in children. We performed a retrospective review of nine children and young adults who underwent PleurX® catheter placement for the palliation of symptoms associated with malignant effusions. Eight of nine demonstrated symptomatic improvement and seven of nine were discharged from the hospital after catheter placement...
June 2014: Pediatric Blood & Cancer
Barbara S den Hollander, Bairbre L Connolly, Lillian Sung, Adam Rapoport, C M Zwaan, Ronald M Grant, Dimitri Parra, Michael J Temple
BACKGROUND: Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. METHODS: Children with MPE/MA who underwent ITC insertion (2007-2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed...
June 2014: Pediatric Blood & Cancer
Daniel Casey, Charles Read, Eric Anderson
SESSION TYPE: Pleural Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Recurrent hepatic hydrothoracies may be difficult to manage. In cases when medical therapies, usually diuretics, have failed to adequately control symptomatic effusion, thoracentesis, thoracostomy tube drainage and pleurodesis have been employed. Tunneled pleural catheters are utilized for control and long-term management of malignant recurrent pleural effusions. We report their successful use in patients with recurrent hepatic hydrothorax refractory to alternative therapies...
October 1, 2012: Chest
Satish Kalanjeri, Mohit Chawla, Nicholas Vander Els, Diane Stover, Robert Lee
SESSION TYPE: Pleural BiomarkersPRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PMPURPOSE: Malignant pleural effusions (MPE) affect 150,000 patients in the US each year. Prognosis is poor and median survival about 6 months. Loculations occur frequently and surgical options are not always suitable in this group of patients. The role of intrapleural alteplase in MPE has never been studied before.METHODS: Chart review was performed on 21 patients (32 instillations) who had received intrapleural alteplase instillations via Pleurx catheter in the last 3 years...
October 1, 2012: Chest
Wasiq Faraz Rawasia, Udit Chaddha, Karim El-Kersh, Rafael L Perez
Krukenberg tumour is a metastatic signet-ring adenocarcinoma of the ovary, usually with a gastrointestinal primary detected metachronously or synchronously. We present here a case of a 48 year-old woman who presented with a prolonged history of dyspnoea on exertion. Workup had revealed a pelvic mass. Thoracocentesis of her pleural effusion, with cytology, and pathology reports from her total abdominal hysterectomy with bilateral salpingo-oophorectomy revealed a carcinoma with signet-ring cells. Immunostains were positive for CDX2, CK7 and CK20, which was highly suggestive of a gastric primary...
2013: BMJ Case Reports
M Dilkaute, B Klapdor, A Scherff, U Ostendorf, S Ewig
OBJECTIVE: In patients with malignant effusions and ECOG 3 - 4 or unexpandable lung, the PleurX® catheter system provides an effective at-home palliation of symptoms associated with recurrent pleural effusions. We investigated the clinical results of patients treated by this method in our population. METHODS: All patients treated with PleurX between June 2005 and September 2010 in our clinical center were recorded using a predefined data sheet. Primary points of interest were complications associated with the insertion procedure, short- and long-term complications after insertion of the catheter, the rate of pleurodesis, the frequency of hospitalizations due to effusion-associated symptoms, time of drainage and survival time after insertion...
November 2012: Pneumologie
Kassem Harris, Michel Chalhoub
Recurrent pleural effusion (RPE) can be encountered in various benign conditions such as inflammatory, infectious, or other systemic diseases (e.g., congestive heart failure (CHF), hepatic hydrothorax, post lung transplants, post coronary artery bypass graft (CABG) surgery, and chronic exudative pleurisy). Each condition is treated based on its unique pathophysiologic characteristics, and medical management is successful in the majority of patients. In rare circumstances, pleural effusions are rapidly recurring despite optimal medical therapy and patients have frequent hospitalisations that require repeated thoracenteses...
November 2012: Heart, Lung & Circulation
Judith White, Grace Carolan-Rees
The PleurX peritoneal drainage catheter for drainage of malignant ascites in a community setting has been evaluated by the NICE Medical Technologies Evaluation Programme. This article outlines the evidence included in the Sponsor's submission, the independent critique by the External Assessment Centre (EAC) and the recommendations made by the Medical Technologies Advisory Committee (MTAC). In accordance with the scope issued by NICE, the intervention technology was the indwelling PleurX peritoneal catheter drainage system, the comparator was large-volume paracentesis (LVP; inpatient or outpatient) and the population was patients with treatment-resistant, recurrent malignant ascites...
September 1, 2012: Applied Health Economics and Health Policy
Michel Chalhoub, Kassem Harris, Michael Castellano, Rabih Maroun, Ghada Bourjeily
PURPOSE: To evaluate the effectiveness of the PleurX catheter in the management of recurrent non-malignant pleural effusions. METHODS: All subjects who underwent a PleurX catheter placement between 2003 and 2009 were evaluated. General demographic data, time to pleurodesis, complications, and a satisfaction questionnaire were collected. The subjects were divided into two groups. Group I included patients with non-malignant effusions and group II included patients with malignant effusions...
2011: Chronic Respiratory Disease
M Blaukovitsch, A Strassburg, E Müller, P Zabel, H-P Hauber
BACKGROUND: The purpose of this retrospective study was to investigate the efficacy and safety of an indwelling pleural device (PleurX, Denver Biomedical, USA) for the treatment of recurrent pleural effusions. In cases when life expectancy tends to be very short and also surgical decortication is not recommended, pleurodesis is another treatment option but requires complete drainage of the whole pleural fluid for optimal results which is sometimes hard to achieve. The PleurX catheter is an alternative therapeutic option...
September 2011: Pneumologie
C R Tapping, L Ling, A Razack
OBJECTIVES: The aim of this article was to assess the success, safety, complication profile and factors associated with long-term patency of tunnelled peritoneal drains (PleurX) in the treatment of refractory malignant ascites. METHODS: Over a 4-year period, 28 consecutive patients (32 drain insertions) with refractory malignant ascites were treated with a PleurX drain. The study group comprised 7 males and 21 females (mean age, 61 years). A combination of fluoroscopic and ultrasound guidance was used to insert 4 drains; the remaining 28 drains were inserted under ultrasound guidance alone...
May 2012: British Journal of Radiology
R Saiz-Mendiguren, M Gómez-Ayechu, J J Noguera, A García-Lallana, C Marginet, D Cano, A Benito
OBJECTIVE: The most common treatment in recurrent malignant ascites is generally temporary peritoneal drainage. We present our experience in placing permanent tunneled catheters in a series of patients and analyze the safety and efficacy of the treatment. MATERIAL AND METHODS: We used total aseptic measures in the interventional ultrasonography suite to place permanent tunneled catheters in 10 patients under ultrasonographic guidance and local anesthesia. RESULTS: The catheters remained patent for a median of 52 days in the nine patients who died...
November 2010: Radiología
N Vakil, J W Su, D P Mason, K M G Reyes, S C Murthy, G B Pettersson
BACKGROUND: Chronic pleural effusion following lung transplantation (LTx) is often responsible for respiratory insufficiency and can lead to lung entrapment. Decortication carries considerable morbidity, and extended use of tube thoracostomy is not practical. We have utilized an indwelling pleurocutaneous catheter in the setting of intractable post-transplant effusion and have reviewed our experience to determine whether this strategy: 1) facilitates resolution of effusion, and 2) adequately palliates lung entrapment...
August 2010: Thoracic and Cardiovascular Surgeon
Pascale Mercky, Lama Sakr, Laurent Heyries, Xavier Lagrange, José Sahel, Hervé Dutau
Refractory hepatic hydrothorax poses a challenging therapeutic dilemma, as treatment options are limited. Herein, we describe the case of a 48-year-old lady with advanced cirrhosis and recurrent transudative pleural effusion despite a sodium-restricted diet, optimal diuretic therapy and transjugular intrahepatic portosystemic shunt. Given the patient's platelet and coagulation disorders, thoracoscopic pleurodesis was deemed unsafe. Instead, a tunneled pleural catheter (PleurX®) was inserted under local anesthesia...
2010: Respiration; International Review of Thoracic Diseases
Enrique Cases, Luis Seijo, Carlos Disdier, María José Lorenzo, Rosa Cordovilla, Francisca Sanchis, Marimar Lacunza, Gregoria Sevillano, Fátima Benito-Sendín
BACKGROUND AND OBJECTIVE: To analyse the effectiveness and safety of the indwelling pleural catheter in the management of recurrent malignant pleural effusion. PATIENTS AND METHODS: A prospective multicentre study was performed in 63 consecutive outpatients from four Spanish hospitals. A total of 43 men and 20 women were included, with a median age of 67 years. In seven of the cases treatment with pleurodesis had failed; in five other cases their lung was trapped; in another five cases after repeat therapeutic thoracocentesis, and the rest of them as a preference choice to pleurodesis...
December 2009: Archivos de Bronconeumología
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