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Annals of Surgical Oncology

, Volume 22, Issue 5, pp 1722–1725 | Cite as

Laparoscopic Evacuation of Mucinous Ascites for Palliation of Pseudomyxoma Peritonei

  • Kaitlyn J. Kelly
  • Joel M. Baumgartner
  • Andrew M. LowyEmail author
Gastrointestinal Oncology

Abstract

Introduction

Accumulation of mucinous ascites causes significant morbidity for patients with unresectable pseudomyxoma peritonei (PMP). The success of paracentesis for mucin evacuation is limited due to the presence of adhesions, disease burden, and the viscous nature of mucinous ascites. We sought to review our experience with laparoscopic evacuation of mucinous ascites for palliation of PMP.

Methods

Records were reviewed for patients who underwent laparoscopy for carcinomatosis secondary to appendix or colon cancer from July 2007 to January 2014. Of 123 patients, 10 were identified who underwent 17 laparoscopic procedures for palliative evacuation of mucinous ascites.

Results

All patients had primary appendiceal cancers and all presented with symptomatic ascites causing abdominal distension and bloating. Pneumoperitoneum was established with a Veress needle or 5-mm optical viewing trocar in the majority of cases (n = 11). In the remaining six cases, an open technique was used and a 10-mm Hasson trocar was placed. There were no trocar-related complications. The median volume of mucin evacuated was 2.0 liters (range 1.7–8.0). All procedures were done as same-day surgeries; no patients required hospitalization. All patients reported symptomatic improvement following the procedure. One patient experienced a grade 1 complication of persistent drainage from one incision, which was managed in the outpatient setting. The median follow-up for all pts was 9.1 months. The median time to recurrent symptoms requiring repeat intervention was 5.3 months.

Conclusions

Laparoscopic evacuation of mucinous ascites for select patients with PMP is feasible and results in significant, durable symptom control with minimal morbidity.

Keywords

Mucinous Adenocarcinoma Veress Needle Pseudomyxoma Peritonei Complete Cytoreduction Optimal Cytoreduction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Turaga KK, Pappas SG, Gamblin T. Importance of histologic subtype in the staging of appendiceal tumors. Ann Surg Oncol. 2012;19:1379–85.CrossRefPubMedGoogle Scholar
  2. 2.
    Moran B, Baratti D, Yan TD, Kusamura S, Deraco M. Consensus statement on the loco-regional treatment of appendiceal mucinous neoplasms with peritoneal dissemination (pseudomyxoma peritonei). J Surg Oncol. 2008;98:277–82.CrossRefPubMedGoogle Scholar
  3. 3.
    Kelly KJ, Nash GM. Peritoneal debulking/intraperitoneal chemotherapy-non-sarcoma. J Surg Oncol. 2014;109:14–22.CrossRefPubMedGoogle Scholar
  4. 4.
    Chua TC, Moran BJ, Sugarbaker PH, et al. Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. J Clin Oncol. 2012;30:2449–56.CrossRefPubMedGoogle Scholar
  5. 5.
    Chua TC, Baker B, Yan TD, Zhao J, Morris DL. Palliative effects of an incomplete cytoreduction combined with perioperative intraperitoneal chemotherapy. Am J Clin Oncol. 2010;33:568–71.CrossRefPubMedGoogle Scholar
  6. 6.
    Glehen O, Mohamed F, Sugarbaker PH. Incomplete cytoreduction in 174 patients with peritoneal carcinomatosis from appendiceal malignancy. Ann Surg. 2004;240:278–85.CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    National Cancer Institute. Common Terminology Criteria for Adverse Events. Version 4.0.: National Cancer Institute, National Institutes of Health; 29 May 2009.Google Scholar

Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Kaitlyn J. Kelly
    • 1
  • Joel M. Baumgartner
    • 1
  • Andrew M. Lowy
    • 1
    Email author
  1. 1.Division of Surgical Oncology, Department of SurgeryUniversity of California San Diego Moores Cancer CenterLa JollaUSA

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