Mesothelioma Treatments

Mesothelioma Surgery - Paracentesis

Mesothelioma is a form of cancer that most commonly develops in the lining of the lungs but can also affect other organs as well. Paracentesis does not cure mesothelioma, but rather it is used as a palliative measure to help improve the patient's quality of life and ease symptoms.

Paracentesis Procedure

The main purpose of paracentesis is to remove fluid that has collected in the abdominal area. Peritoneal fluid that builds up in the abdominal cavity is known as ascites and can cause a number of problems. Healthy men have little or no intraperitoneal fluid, but women may normally have as much as 20 mL depending on the phase of the menstrual cycle.

Ascites associated with liver disease are rarely painful, while ascites caused by malignant mesothelioma can be very painful. Paracentesis can help to relieve the pain and pressure in the abdomen that is associated with ascites, which can cause complications involving the bowels, kidneys, and other parts of the digestive system.

There are four steps to conducting a paracentesis:

Step 1: Ultrasound scan before the procedure

The radiologist will mark the spot for paracentesis. The first of two things that the doctor will make note of are the distance from the skin to the fluid. Having this information gives the doctor a clear indication of how deep he has to go with the needle before getting fluid in the syringe. The second important information from the ultrasound is the distance to the midpoint of the collection site, which tells the doctor how deep he should thread the catheter.

Step 2: Patient preparation

After getting the necessary information about a specific patient, the doctor will discuss the risks, benefits and alternatives to the patient. The doctor will request that the patient urinate before the procedure then lie on a bed with the head slightly elevated.

Step 3: Procedure

Preparation for the procedure: the doctor will clean an area about two finger widths below the patient's belly button. Once the area is sterilized and anesthetized, a catheter will be inserted about 2 centimeters into the peritoneal cavity with a needle. The needle will be removed during the procedure. After the fluid has been removed through the catheter will be removed. The patient will need to remain lying down for several hours after the conclusion of treatment.

Step 4: Laboratory results

After the procedure, the doctor will send the fluid collected to the lab for analysis and use in further disease diagnosis.

Complications

Paracentesis is uncomfortable, but few risks are typically involved. When the needle is inserted, patients may feel pain or pressure. Those who undergo this procedure may also experience dizziness, especially with large amounts of fluid removal. Doctors may insert an IV to help introduce necessary fluids into the blood stream to help prevent blood pressure problems and shock.

While the procedure is relatively simple, there are some potential complications, including a persistent leak from the puncture site, abdominal wall hematoma, perforation of the bowel and several other problems.

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