title: Tenckhoff tunneled peritoneal catheter placement in the palliative treatment of malignant ascites: technical results and overall clinical outcome.
abstract: BACKGROUND
  To assess the technical and clinical outcome of percutaneous insertion of tunneled peritoneal catheters in the palliative treatment of refractory malignant ascites and to determine the safety and feasibility of intraperitoneal administration of cytotoxic drugs through the tunneled catheter.
  
  
  METHODS
  Consecutive patients palliatively treated with a tunneled peritoneal catheter to drain the malignant ascites were identified. Patients' medical history, procedural and clinical follow-up data, including complications and estimated survival, were reviewed. Additionally, a sub analysis of the patients with widespread ovarian cancer and refractory ascites treated with or without intraperitoneal administration of cytotoxic drugs was made.
  
  
  RESULTS
  In all 94 patients it was technically feasible to insert the peritoneal drainage catheter and to drain a median of 3260 cc (range 100 cc - 8500 cc) of malignant ascitic fluid. Post procedural complications included catheter infection (n = 2; 2%), fluid leakage around the entry site (n = 4; 4%), catheter occlusion (n = 2; 2%), sleeve formation around the catheter tip (n = 1; 1%) and accidental loss of the catheter (n = 1; 1%). There was no increase in catheter infection rate in patients treated with or without intraperitoneal administration of cytotoxic drugs. Median overall survival after catheter insertion is 1.7 months.
  
  
  CONCLUSIONS
  Percutaneous insertion of a tunneled Tenckhoff catheter for the palliative drainage of malignant ascites and intraperitoneal infusion of cytotoxic drugs is feasible and associated with a very low complication rate, including catheter infection. These tunneled peritoneal lines are beneficial for symptomatic palliative treatment of refractory ascites and allow safe intraperitoneal chemotherapy.
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Indesteege
authors.affiliation: Department of Biostatistics and and Statistical Bioinformatics, KU Leuven and Universiteit Hasselt, Belgium.
authors.forename: Annouschka
authors.initials: A
authors.lastname: Laenen
authors.affiliation: Department of Digestive Oncology, University Hospitals Leuven, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Verslype
authors.affiliation: Department of Gynaecology, University Hospitals Leuven, Belgium.
authors.forename: Ignace
authors.initials: I
authors.lastname: Vergote
authors.affiliation: Department of Digestive Oncology, University Hospitals Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Prenen
keywords: malignant ascites; palliation; peritoneal catheter