Improved quality of life for malignant ascites patients by Denver peritoneovenous shunts.

BACKGROUND: Intractable ascites secondary to malignant disease deteriorates the patients' quality of life. PATIENTS AND METHODS: Thirty-three patients, who had undergone Denver peritoneovenous shunt for the treatment of ascites associated with malignant tumor from May 1998 to February 2004, were retrospectively analyzed. RESULTS: Post-operative complications had occurred in twelve patients, including disseminated intravascular coagulation in eight, pulmonary edema in three and wound hematoma in one. The patients' post-operative mean survival was 54.5 days with occlusion occurring in four (12.1%). Comparison of pre- and postoperative values showed a significant decrease of body weight and abdominal girth. Thirteen patients needed no post-operative therapy for ascites, whereas 17 patients could tentatively remain at home or be discharged. CONCLUSION: The Denver shunt for malignant ascites is useful in improving quality of life, if indications are selected properly. Further experience and discussion are necessary to establish the patient selection criteria.

[A case of malignant lymphoma of the stomach in which preoperative chemotherapy provided a complete response].

We have encountered a case of malignant lymphoma of the stomach in which a complete remission was confirmed in a resected specimen after chemotherapy. A 75-year-old woman complained of vomiting blood. A biopsy from gastric endoscopy indicated malignant lymphoma of diffuse large B-cell type. The patient was assumed to be inoperable due to enlargement of the tumor and lymph node metastasis, and THP-COP chemotherapy was carried out. After four courses of the THP-COP regimen, endoscopic examination revealed a significant tumor reduction. Total gastrectomy and splenectomy with lymph node dissection (D2) were performed after chemotherapy. No tumor cells were detected in any sections of the specimen or regional lymph nodes.