Clinical outcomes following insertion of second-generation (Aspira®) tunneled indwelling peritoneal catheters to treat malignant ascites

Purpose To describe clinical outcomes following insertion of a new tunneled indwelling peritoneal catheter (IPC) to alleviate ascites-related symptoms. Methods This retrospective, single-center study investigates the outcomes of consecutive patients who underwent insertion of a next-generation IPC for drainage of malignant ascites between 2016 and 2023. Patients were eligible for IPC if their ascites required ≥ 2 drainage procedures per month; patients were excluded if they had positive ascitic fluid culture prior to placement, deranged clotting, loculated ascites, or low likelihood of survival with an expected survival time < 3 weeks based on the treating physician’s clinical judgment. Study outcomes included technical success, symptomatic improvements following catheter placement, catheter days, and complications. Results A total of 124 patients (40 males, 84 females) were analyzed. The mean age was 60.6 ± 11.3 years. Device implantation was successful in all patients. The mean number of catheter days was 103.3 ± 77.8. Thirty days post device insertion, patients experienced significant improvement in all ascites-related symptoms (i.e., pain, general weakness, nausea, depression, anxiety, drowsiness, appetite, sense of well-being, shortness of breath, abdominal bloating, impaired mobility; all p < 0.001). Significant improvement persisted 90 days following catheter insertion for most symptoms, except for anxiety, appetite, sense of well-being, and impaired mobility. Twenty-six patients (21.0%) experienced minor catheter-related complications. Common complications included cellulitis ( n = 7), treated with antibiotic, and ascites leakage from the site of implantation within 48 h of the procedure ( n = 5) which was corrected via suture. Conclusion Tunneled IPCs are associated with a tolerable safety profile and provide meaningful improvement in the quality of life for patients with symptomatic malignant ascites. Complications can be readily managed but necessitate reliable aftercare and follow-up.