Paracentesis is used to treat peritoneal effusion, or fluid buildup.
Paracentesis is a treatment used for patients with peritoneal mesothelioma.
As a palliative treatment, paracentesis improves symptoms, but not prognosis.
There are both benefits and complications to paracentesis surgery.
Paracentesis is a surgical procedure typically done palliatively to improve symptoms for peritoneal mesothelioma patients. A paracentesis can also be performed as a biopsy to gain a fluid sample for analysis before making a definitive cancer diagnosis. For all purposes, a paracentesis is considered minimally invasive to the patient.
Paracentesis and Mesothelioma Treatment
Peritoneal effusion, or ascites, is a common symptom for patients diagnosed with malignant peritoneal mesothelioma. Patients may typically undergo standard treatments like surgery, chemotherapy or radiation therapy, but palliative treatments may also be part of their treatment plan to help manage mesothelioma symptoms.
Around 10% of peritoneal effusion cases are caused by aggressive cancers, like malignant mesothelioma. The cancer causes the body to produce excess fluid that accumulates in the peritoneal cavity. This can then put pressure on the abdomen, leading to pain, difficulty breathing and other symptoms.
Peritoneal Effusion Symptoms
- Abdominal pain
- Chest pain
- Difficulty breathing
- Loss of appetite
- Swelling in the abdomen
- Weight gain
By performing a paracentesis, mesothelioma specialists can potentially relieve symptoms for the patient, improving their comfort and quality of life. Similar symptoms and concerns arise for malignant pleural mesothelioma patients facing pleural effusion, or buildup of fluid in the pleural cavity. With the same goal as a paracentesis, a pleurodesis can be performed palliatively to remove excess fluid.
Patients will generally undergo a paracentesis alongside other mesothelioma treatments like chemotherapy or radiation. This procedure is minimally invasive, so there aren’t as many risks and complications as an invasive mesothelioma surgery. Paracentesis surgeries are typically out-patient procedures performed in a doctor’s office, medical center, imaging center or hospital.
To begin the procedure, the abdominal area is cleaned and numbed with a local anesthetic prior to needle insertion. A long hollow needle or tube is inserted into the abdominal cavity at the site of fluid buildup. Sometimes a CT scan or ultrasound is performed at the same time for the physician to accurately guide the needle to the proper location. Once the needle is fully inserted, the fluid is extracted. During this point of the procedure, patients may feel a slight pulling sensation. The needle is then removed with a bandage placed over the injection site.
The simple procedure is generally pain-free for the patient. It’s possible that they may experience lightheadedness and should let their doctor know immediately if they feel sick or unwell. Recovery is typically quick with possible drainage from the insertion site for a day or two after the procedure, especially if a lot of fluid is removed. If fluid buildup returns, multiple paracentesis sessions may be performed.
Paracentesis Risks and Complications
As a minimally invasive procedure, a paracentesis generally has less risk than an invasive surgery. However, there are still potential complications that can occur that mesothelioma patients should be aware of and look out for.
Common Paracentesis Risks
- Bleeding and infection
- Kidney malfunction (heightened risk for those with kidney disease or kidney disease risk factors)
- Perforation or puncturing of the bowel, bladder or blood vessel
- Shock, especially if a large amount of fluid is removed, causing low blood pressure
- Transfer of cancer cells from one area of the abdomen to another
Potential risks and complications will vary from patient to patient and may be worse for older patients, those in poor health or those diagnosed with stage 4 mesothelioma. Before deciding to undergo any palliative treatment, patients should seek professional medical advice to ensure the best treatment option for their specific case. Clinical trials for mesothelioma continue to explore palliative treatment options and what is best for improving patient symptoms with minimal risk.