![]() A prospective database of all cases of tunnelled long-term drain (PleurX UK Medical, Sheffield, UK) insertion is kept in our department. Our hospital research and ethics committee granted approval for this service evaluation. A secondary aim was to identify predictors of successful long-term catheter patency. Furthermore, we wanted to assess the number of interventions and repeat hospital admissions required to maintain patency of the indwelling catheter. The aims of this study were to assess the success, long-term patency and complications associated with the use of PleurX drains in the management of malignant ascites. This also allows patients to limit the potential complications and frequent hospital admissions previously required for repeated paracentesis. ![]() Once the patient and their family have been shown how to use the drainage system and vacuum bottles, and how to recognise complications, patients can control and manage their ascites safely at home with minimal district nurse input. ![]() The PleurX drain is a tunnelled indwelling peritoneal catheter that can be managed at home to remove small (500 ml) aliquots of ascites on a regular basis or when it becomes symptomatic. Various studies have found that the PleurX catheter is an effective option for the management of malignant ascites with a low complication rate. These approaches can have a significant impact on patients’ remaining quality of life. Current treatment strategies for the palliation of these symptoms include repeated paracentesis, placement of indwelling intraperitoneal catheters, peritoneovenous shunting, intraperitoneal chemotherapy, diuretic treatment and dietary restrictions. ![]() Distressing symptoms include tense abdominal distension, early satiety, nausea and vomiting, reflux oesophagitis, shortness of breath, lower limb oedema, fatigue and reduced mobility. Intractable ascites is usually caused by peritoneal infiltration, liver metastases causing secondary portal venous compression, lymphangitic carcinomatosis, lymphatic obstruction or a combination of these factors. The development of ascites is usually a manifestation of terminal metastatic malignancy with anticipated life expectancy ranging from 1 to 4 months. ![]()
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