Introduction/Background Patients with advanced ovarian cancer and some patients with advanced endometrial cancer need repeated drainage before the operation because malignant ascites may cause shortness of breath, bloating, nausea and vomiting, and failed renal function. Although parasynthesis and catheter drainage relieve the symptoms, the question of how long should the drain stay in place remains unanswered. To evaluate the benefits and harms of two practices (transient or long-term drainage) in the management of drains for malignant ascites in the care of women with advanced or recurrent gynecological cancer.

Methodology A retrospective cohort study was conducted and benefits and adverse outcomes such as symptom relief and duration, need for repeated drainage, and the rates of infection, perforation of a viscera, peritonitis, hypotension, and catheter blockage were compared. All catheterizations were performed under ultrasonographic guidance. Gynecologic oncologists prefer transient catheterization while interventional radiology referred patients are drained with a catheter left in situ.

Results A total of 106 transient and 27 long-term (until the operation) catheter-placed women with symptomatic malignant ascites were studied on their retrospective file records. There was no statistically significant difference between the groups in terms of symptom relief and duration and need for repeated drainage. The infection rate was found to be higher in the long-term catheterization group and in one perforation of the viscera which necessitated right hemicolectomy without malignant reason. There was no difference between hypotension, catheter blockage.

Conclusion Our results suggest that long-term catheterization was not advantageous. Furthermore, infection and complication rates are higher. Therefore, gynecologic cancer patients with symptomatic malignant ascites are recommended to be managed by transient drainage until the operation. The need for randomized controlled trials still remained.

Disclosures None.