Efficacy of Pigtails for the Management of Refractory Malignant Ascites or Effusion: A Systematic Retrospective Chart Review of an Institution

Authors

  • Faryal Farooq Department of Radiology, Dow University of Health Sciences
  • Nasreen Naz Department of Radiology, Dow University of Health Sciences.
  • Maryam Asghar Department of Radiology, Gambat Institute of Medical Sciences, Gambat.
  • Amjad Sattar Department of Radiology, Dow University of Health Sciences.
  • Nauman al Qamari Department of Radiology, Dow University of Health Sciences.
  • Wiqar Ahmad Department of General Medicine, Northwest General Hospital and Research Centre, Peshawar.
  • Parvez Ahmed Department of Radiology, Dow University of Health Sciences.
  • Hassan Mumtaz Department of Clinical Investigation, Maroof International Hospital.

DOI:

https://doi.org/10.47489/szmc.v37i2.371

Keywords:

Ascites; Malignant; Pigtail catheter; Pigtail; Pleural effusion; Complications; quality of life; symptoms; palliation.

Abstract

Introduction: Malignant ascites and effusions have been observed in various diseases and persistent ascites or effusion from any of causes prompts the need for urgent first-line therapies. Refractory forms of ascites and effusion can cause noteworthy symptoms and can severely affect the quality of life (QoL). We therefore assessed the viability, efficacy, and patient-reported results of pigtails in the administration of refractory ascites or effusion due to malignancy.

Aims & Objectives: We aimed to assess the viability, efficacy and patient-reported results of pigtails in the administration of refractory ascites or effusion by malignancy.

Place and duration of study: It was conducted in Vascular Interventional Radiology Department, Dow Institute of Radiology, Dow University of Health Sciences, Ojha Campus for a period of 18 months between January 2021 and June 2022.

Material & Methods: A retrospective chart review from a single center was done. All available data of the Interventional Radiology Department was utilized to identify patients(n=65) with refractory malignant ascites or effusion who underwent pigtail placement. Data analysis was performed using SPSS version 21, p?0.05 was taken as significant. Results: Procedural success rate was 100% for placement and similarly no mortality was observed. Duodenal, liver and ovarian cancer was the primary source of malignancy. The catheters, 8Fr (n=45, 69.20%) and10Fr (n=20, 30.80%) were implanted. Leakage was the highest experienced complication followed by dislodgement. Overall catheter mean survival time was [23.37days, 95%:21.63- 25.10]. The estimated mean [(24.46, 95%21.98-26.94 Vs 22.53, 95%20.08-24.97)]

duration of catheter dwelling time for pleural effusion was greater than that of ascites (p>0.05). Overall, estimated mean time for 8Fr catheter was greater than that of 10 Fr (p=0.048). Infection and leakage had an estimated mean catheter survival time lower than that of dislodgment and occlusion [log rank-chi square 13.64,p=0.003].

Conclusion: Procedural success rate achieved was 100% and acceptable outcomes in terms of complications and catheter time. These minimally invasive treatment options should be utilized to soothe symptoms and improve the QoL.Furthermore, experimental studies with bigger sample size assessing the adverse outcome and ascertaining the possible cost savings should be performed.

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Published

2023-04-28

How to Cite

1.
Faryal Farooq, Nasreen Naz, Maryam Asghar, Amjad Sattar, Nauman al Qamari, Wiqar Ahmad, Parvez Ahmed, Hassan Mumtaz. Efficacy of Pigtails for the Management of Refractory Malignant Ascites or Effusion: A Systematic Retrospective Chart Review of an Institution. Proceedings S.Z.M.C [Internet]. 2023 Apr. 28 [cited 2024 Jun. 15];37(2):35-41. Available from: http://proceedings-szmc.org.pk/index.php/szmc/article/view/371