Humans ; Tolvaptan/therapeutic use* ; Ascites/drug therapy* ; Receptors, Vasopressin ; Liver Cirrhosis/drug therapy* ; Sodium

This study aims to explore the effects of chemical ingredient groups B and C in Kansui Radix stir-fried with vinegar on the diversity of gut microbiota in the rat model of malignant ascites, identify the key differential microbial taxa, and reveal the biological mechanism of water-expelling effect of the two chemical ingredient groups. The rat model of malignant ascites induced by Walker-256 cells was established, and phenolphthalein was used as the positive drug. The rats were orally administrated with corresponding agents for consecutive 7 days. On day 6, fresh feces samples were collected from the rats, and 16 S rDNA high-throughput sequencing and GC-MS were employed to determine the composition of gut microbiota and the content of short-chain fatty acids, respectively. On day 7, serum and intestinal tissue samples were collected for the determination of related indicators. Compared with the control group, the model group showed decreased feces volume and urine volume(P<0.01), increased volume of ascites and levels of Na~+, K~+, and Cl~- in urine(P<0.01), down-regulated mRNA and protein levels of intestinal AQP8(P<0.01), lowered abundance of beneficial Lactobacillus(P<0.01) while risen abundance of potential pathogenic Lachnospiraceae and Anaeroplasma(P<0.01), and reduced content of short-chain fatty acids(P<0.01). Compared with the model group, administration with chemical ingredient groups B and C alleviated all the above indicators(P<0.01). In conclusion, chemical ingredient groups B and C in Kansui Radix stir-fried with vinegar could alleviate the disordered gut microbiota in rats with malignant ascites to expel water through increasing the abundance of beneficial Lactobacillus and reducing the abundance of harmful Lachnospiraceae and Anaeroplasma. This study can provide a reference for the reasonable clinical application of Kansui Radix stir-fried with vinegar.
Acetic Acid/chemistry* ; Animals ; Ascites/drug therapy* ; Euphorbia/chemistry* ; Gastrointestinal Microbiome ; Plant Roots/chemistry* ; Rats

ascites, and presence of operative complications were independently and significantly associated with postoperative complications.CONCLUSION: Morbidity of extensive surgical approach should be kept in mind in ovarian cancer surgery aimed at leaving no residual tumor. Patient-based management with an appropriate preoperative evaluation may avoid morbidity of extended/extensive surgical approaches.]]>
Ascites ; Drug Therapy ; Humans ; Intensive Care Units ; Intraoperative Complications ; Length of Stay ; Neoplasm, Residual ; Ovarian Neoplasms ; Postoperative Complications

3.38, PLR >210, CA125 >365, advanced stage, suboptimal disease, serous type, and ascites were significant predictive factors for platinum resistance. However, only NLR >3.38 and advanced stage were independent predictive factors with an adjusted odds ratio of 1.880 and 3.333, respectively. Regarding factors associated with poor survival outcomes, only PLR >210 and advanced stage were independent factors, with a hazard ratio of 1.578 and 3.994, respectively.CONCLUSION: High NLR and advanced stage were potential independent predictive factors for platinum resistance, whereas high PLR and advanced stage were potential independent predictive factors for poor survival outcomes.]]>
Ascites ; Blood Platelets ; Drug Therapy ; Fallopian Tubes ; Female ; Humans ; Lymphocytes ; Medical Records ; Multivariate Analysis ; Neutrophils ; Odds Ratio ; Ovarian Neoplasms ; Platinum ; Prognosis ; Retrospective Studies ; ROC Curve

PURPOSE: Gastric cancer (GC) patients with peritoneal metastasis (PM) have poor prognosis. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in combination with systemic chemotherapy is a novel treatment option for patients in stage IV of the disease. MATERIALS AND METHODS: Between November 2015 and June 2018, prospective data collection was performed in 24 patients with GC and PM (median age, 57; range, 44–75 years). These patients underwent 46 PIPAC procedures with a median number of 2 interventions per patient (range, 1–6). A laparoscopic access was used and a combined therapy of cisplatin and doxorubicin aerosol was administered. RESULTS: The median peritoneal carcinomatosis index before the 1st PIPAC was 14 (range, 2–36), and the median ascites volume in patients before the 1st PIPAC was 100 mL (range, 0–6 mL, 300 mL). Eleven patients, who received 2 or more PIPAC procedures, had decreased and stable volumes of ascites, while only 3 patients displayed increasing volume of ascites. The median overall survival was 121 days (range, 66–625 days) after the 1st PIPAC procedure, while 8 patients who received more than 3 PIPAC procedures had a median survival of 450 days (range, 206–481 days) (P=0.0376). CONCLUSIONS: Our data show that PIPAC is safe and well tolerated, and that the production of ascites can be controlled by PIPAC in GC patients. Patients, who received 2 or more PIPAC procedures, reported a stable overall quality of life. Further studies are required to document the significance of PIPAC as a palliative multimodal therapy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03100708
Ascites ; Carcinoma ; Cisplatin ; Data Collection ; Doxorubicin ; Drug Therapy* ; Humans ; Neoplasm Metastasis* ; Prognosis ; Prospective Studies ; Quality of Life ; Stomach Neoplasms*

OBJECTIVE: To describe the nutritional status of women with peritoneal metastasis (PM) from recurrent ovarian, fallopian, or peritoneal cancer and to assess longitudinal variations of the cachexia-anorexia syndrome (CAS) during palliative pressurized intraperitoneal aerosol chemotherapy (PIPAC). METHODS: Nutritional assessment included body mass index (BMI), bioelectrical impedance analysis (BIA), and blood chemistry. CAS presence/absence was recorded before and during repeated cycles (1–11) of PIPAC. RESULTS: Eighty-four patients with peritoneal cancer (n=5) or PM from recurrent ovarian (n=77) or fallopian tube (n=2) cancer were included. At baseline, resting metabolism (RM) (1,432±172 kcal/day), visceral fat level (7.5±3.2), skeletal muscle mass (27.2%±4.6%), upper arm circumference (27.9±4.6 cm), lower leg circumference (35.1±3.9 cm), serum parameters (albumin [3.5±0.7 g/dL], total protein [6.3±0.9 g/dL], and transferrin [202±60 mg/dL]) were below normal limits. C-reactive protein (CRP) (4.3±6.8 mg/dL), caliper body fat (35.7%±6.3%), and total body fat mass (35.6%±8.5%) were above normal limits. Nineteen/84 (23%) patients had CAS at baseline. Deterioration or stabilization/improvement of CAS was observed in 9/55 (16.4%) and 46/55 (83.6%) patients with follow-up data, respectively. Baseline body fat mass, visceral fat level, skeletal muscle mass, caliper body fat, BMI, ascites, Karnofsky index, RM, and CRP, as well as tumor response were not predictive of CAS deterioration. CONCLUSION: Nutritional decline and onset or deterioration of CAS are difficult to predict. Careful measuring and monitoring of nutritional parameters and CAS in all patients seems to be necessary in order to identify those patients in need of enteral/parenteral nutrition support.
Adipose Tissue ; Anorexia* ; Arm ; Ascites ; Body Mass Index ; C-Reactive Protein ; Cachexia* ; Chemistry ; Drug Therapy* ; Electric Impedance ; Fallopian Tubes ; Female ; Follow-Up Studies ; Humans ; Intra-Abdominal Fat ; Karnofsky Performance Status ; Leg ; Metabolism ; Muscle, Skeletal ; Neoplasm Metastasis* ; Nutrition Assessment ; Nutritional Status* ; Ovarian Neoplasms ; Transferrin

Signet ring cell carcinoma is a rare form of gallbladder cancer and has a worse prognosis. Since few cases have been reported, information regarding the behavior and prognosis of the gallbladder carcinoma is limited. About twenty four cases of gallbladder signet ring cell carcinoma have been reported so far. We present a rare case of primary signet ring cell carcinoma of the gallbladder. A 58-year-old male presented with epigastric pain. Abdominal computed tomography showed diffuse gallbladder wall thickening with enhancement, gallstones, and choledocholithiasis. After endoscopic treatment of choledocholithiasis, laparoscopic cholecystectomy was performed. Pathologic examination of the resected gallbladder revealed adenocarcinoma of signet ring cell type in the epithelium. Immunohistochemical stain for cytokeratin 7 was positive for tumor cells. The final pathologic diagnosis was primary signet ring cell carcinoma of the gallbladder. Lymph node metastasis was detected and he received chemotherapy and radiotherapy. After one year of follow-up, bone metastasis in the lumbar spine and malignant ascites were found. The patient is being provided with palliative care.
Adenocarcinoma ; Ascites ; Carcinoma, Signet Ring Cell* ; Cholangitis ; Cholecystectomy, Laparoscopic ; Cholecystitis* ; Cholecystitis, Acute ; Choledocholithiasis ; Diagnosis ; Drug Therapy ; Epithelium ; Follow-Up Studies ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Humans ; Keratin-7 ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Palliative Care ; Prognosis ; Radiotherapy ; Spine

PURPOSE: CO₂ leakage along the trocar (chimney effect) has been proposed to be an important factor underlying port-site metastasis after laparoscopic surgery. This study aimed to test this hypothesis by comparing the incidence of port-site metastasis between B-ultrasound-guided and laparoscopically-assisted hyperthermic intraperitoneal perfusion chemotherapy (HIPPC). MATERIALS AND METHODS: Sixty-two patients with malignant ascites induced by gastrointestinal or ovarian cancer were divided into two groups to receive either B-ultrasound-guided or laparoscopically-assisted HIPPC. Clinical efficacy was assessed from the objective remission rate (ORR), the Karnofsky Performance Status (KPS) score, and overall survival. The incidence of port-site metastasis was compared between the two groups. RESULTS: Patients in the B-ultrasound (n=32) and laparoscopy (n=30) groups were comparable in terms of age, sex, primary disease type, volume of ascites, and free cancer cell (FCC)-positive ascites. After HIPPC, there were no significant differences between the B-ultrasound and laparoscopy groups in the KPS score change, ORR, and median survival time. The incidence of port-site metastasis after HIPPC was not significantly different between the B-ultrasound (3 of 32, 9.36%) and laparoscopy (3 of 30, 10%) groups, but significantly different among pancreatic, gastric, ovarian, and colorectal cancer (33.33, 15.79, 10.00, and 0.00%, p<0.001). CONCLUSION: The chimney effect may not be the key reason for port-site metastasis after laparoscopy. Other factors may play a role, including the local microenvironment at the trocar site and the delivery of viable FCCs (from the tumor or malignant ascites) to the trauma site during laparoscopic surgery.
Ascites ; Colorectal Neoplasms ; Drug Therapy* ; Humans ; Incidence ; Karnofsky Performance Status ; Laparoscopy ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Perfusion* ; Surgical Instruments ; Treatment Outcome

Adult ; Aged ; Ascites ; drug therapy ; etiology ; therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; complications

Some patients have ascites without having liver disease, so it is important to analyze the cause of these ascites. Tuberculous peritonitis is an infectious disease characterized by lymphocyte-dominant exudative ascites. In contrast, myxedema ascites is a very rare disease characterized by a high serum/ascites albumin gradient (SAAG) with hypothyroidism. We herein report a case involving a 48-year-old woman with both diseases simultaneously. She was hospitalized because of massive ascites, generalized edema, and a puffy face. Hypothyroidism was confirmed by thyroid function tests. Her ascitic fluid had a high SAAG; no other specific findings were identified by cytology, culture, or computed tomography. Three months after initiating drug therapy for the hypothyroidism, the patient's systemic edema improved but the ascites recurred. Accordingly, diagnostic laparoscopy was performed, and tuberculous peritonitis was confirmed. As seen in this case, when myxedema ascites is associated with tuberculous peritonitis, an accurate diagnosis may be challenging.
Ascites* ; Ascitic Fluid ; Communicable Diseases ; Diagnosis ; Drug Therapy ; Edema ; Female ; Humans ; Hypothyroidism ; Laparoscopy ; Liver Diseases ; Middle Aged ; Myxedema* ; Peritonitis, Tuberculous* ; Rare Diseases ; Thyroid Function Tests