Therapeutic application of percutaneous peritoneovenous (Denver) shunt in treating chylous ascites in cancer patients Journal Article

   


Authors: Yarmohammadi, H.; Brody, L. A.; Erinjeri, J. P.; Covey, A. M.; Boas, F. E.; Ziv, E.; Maybody, M.; Gonzalez-Aguirre, A. J.; Brown, K. T.; Sheinfeld, J.; Getrajdman, G. I.
Article Title: Therapeutic application of percutaneous peritoneovenous (Denver) shunt in treating chylous ascites in cancer patients
Abstract: Purpose: To evaluate the safety and efficacy of percutaneous peritoneovenous shunt (PPVS) placement in treating intractable chylous ascites (CA) in patients with cancer. Materials and Methods: Data from 28 patients with refractory CA treated with PPVS from April 2001 to June 2015 were reviewed. Demographic characteristics, technical success, efficacy, laboratory values, and complications were recorded. Univariate and multivariate logistic regression analysis was performed. Results: Technical success was 100%, and ascites resolved or symptoms were relieved in 92.3% (26 of 28) of patients. In 13 (46%) patients with urologic malignancies, whose ascites had resulted from retroperitoneal lymph node dissection, the ascites resolved, resulting in shunt removal within 128 days +/- 84. The shunt provided palliation of symptoms in 13 of the remaining 15 patients (87%) for a mean duration of 198 days +/- 214. Serum albumin levels increased significantly (21.4%) after PPVS placement from a mean of 2.98 g/dL +/- 0.64 before the procedure to 3.62 g/dL +/- 0.83 (P < .001). The complication rate was 37%, including shunt malfunction/occlusion (22%), venous thrombosis (7%), and subclinical disseminated intravascular coagulopathy (DIC) (7%). Smaller venous limb size (11.5 F) and the presence of peritoneal tumor were associated with a higher rate of shunt malfunction (P < .05). No patient developed overt DIC. Conclusions: PPVS can safely and effectively treat CA in patients with cancer, resulting in significant improvement in serum albumin in addition to palliation of symptoms.
Keywords: diagnosis; experience; surgery; resection; children; management; lymph-node dissection; lymphangioleiomyomatosis; retroperitoneal lymphadenectomy; successful; venous shunt
Journal Title: Journal of Vascular and Interventional Radiology
Volume: 27
Issue: 5
ISSN: 1051-0443
Publisher: Elsevier Science, Inc.  
Date Published: 2016-05-01
Start Page: 665
End Page: 673
Language: English
ACCESSION: WOS:000375372900009
DOI: 10.1016/j.jvir.2015.12.014
PROVIDER: wos
PUBMED: 26965362
PMCID: PMC5060070
Notes: Article -- Source: Wos
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MSK Authors
  1. George I Getrajdman
    117 Getrajdman
  2. Anne Covey
    157 Covey
  3. Majid Maybody
    96 Maybody
  4. Joel Sheinfeld
    245 Sheinfeld
  5. Lynn Brody
    117 Brody
  6. Karen T Brown
    178 Brown
  7. Joseph Patrick Erinjeri
    175 Erinjeri
  8. Hooman Yarmohammadi
    114 Yarmohammadi
  9. Franz Edward Boas
    76 Boas
  10. Etay Ziv
    97 Ziv
  11. Adrian Jose Gonzalez Aguirre
    30 Gonzalez Aguirre
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