Peritoneo-cystic shunt for malignant ascites

Frederick Stehman, Clarence E. Ehrlich

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Peritoneo-venous shunting has been used extensively in the treatment of benign ascites and, to a limited extent, in the palliative management of malignant ascites. Acceptance of this therapy for malignant ascites has been slow because of concern over intravascular dissemination of disease. Recently a patient with advanced drug-resistant ovarian carcinoma was treated with peritoneo-cystic shunt. This patient's tumor had progressed on multiple chemotherapeutic agents. She continued to work 40 hr per week but her activity was limited by massive ascites. The Denver Shunt (Storz) was selected in preference to the strut-type shunt. The Denver Shunt has a miter valve which is less likely to become occluded by fibrinous and cellular debris, and manual compression of the pumping chamber allows flushing and control of flow. This patient's shunt remained patent for 5 months, until her death, documented by urine cytology and cystoscopy. Initial control of ascites was only fair, probably due to the virtual absence of a pressure gradient between the peritoneal cavity and the bladder. Without a pressure gradient, spontaneous flow would be expected to be nil. Though feasible and well tolerated, this technique is probably not useful in the management of malignant ascites. If modifications of the device could be made to increase the manual flow rate, then this technique might be acceptable.

Original languageEnglish
Pages (from-to)402-407
Number of pages6
JournalGynecologic Oncology
Volume18
Issue number3
DOIs
StatePublished - 1984

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Ascites
Pressure
Cystoscopy
Peritoneal Cavity
Cell Biology
Urinary Bladder
Urine
Carcinoma
Equipment and Supplies
Therapeutics
Pharmaceutical Preparations
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Peritoneo-cystic shunt for malignant ascites. / Stehman, Frederick; Ehrlich, Clarence E.

In: Gynecologic Oncology, Vol. 18, No. 3, 1984, p. 402-407.

Research output: Contribution to journalArticle

Stehman, Frederick ; Ehrlich, Clarence E. / Peritoneo-cystic shunt for malignant ascites. In: Gynecologic Oncology. 1984 ; Vol. 18, No. 3. pp. 402-407.
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