Repeated needle thoracocentesis, tube thoracotomy, or pleurodesis are generally performed as a palliative treatment for malignant pleural effusion. However, these methods have an unsatisfactory success rate, require lengthy hospital stays, and induce pain and various inconvenience accompanying frequent treatment or catheterization, indicating unsatisfactory palliative care. Here, we experienced a case of malignant pleural effusion treated by pleuroperitoneal shunt. The patient was suffering from lung cancer in his eighties. Although the patient wished to be treated at home, uncontrollable pleural effusion forced him to remain in the hospital. By inserting Denver pleuroperitoneal shunt (Denver Biomaterials, Inc., Denver, CO, USA), he could return home. This method may be an effective treatment option in palliative care, particularly palliative home care, for patients with malignant pleural effusions. Palliat Care Res 2008; 3(2): 326-330

Purpose: The aim of this study was to clarify the current state and effectiveness of antibiotic use in our palliative care unit (PCU). Methods: Among the cancer patients hospitalized in our PCU between May 1, 2012 and April 30, 2013, the subjects of this study were treated with parenteral antibiotics for infections. All data were retrospectively collected from medical records. Results: Parenteral antibiotics were prescribed in 44.3% of all. The most common sites of infections were the respiratory tract (63.6%) and the urinary tract (18.2%). In 59.1% of the cases, the outcome of use of antibiotics was helpful, in 9.1% of cases there was no change, in 13.6% of cases it was unhelpful, and in 18.2% of cases it could not be assessed. The outcome of antibiotic use was supposed to be excellent for urinary tract infections, but defective for terminal cases near death. Conclusion: The use of antibiotics is common in PCU and the responsiveness of the antibiotics could be different among certain subgroups.

Purpose: Although case reports on the use of octreotide for malignant ascites are occasionally seen, it remains unclear whether or not octreotide is effective in such cases. The aim of this study was to clarify the utility of octreotide for malignant ascites. Methods: This study was a retrospective study based on a survey of medical records. The subjects were taken from among cancer patients at our hospital who were given octreotide between April 1, 2008 and October 31, 2011 with the aim of reducing gastrointestinal symptoms accompanying gastrointestinal obstruction. These subjects were patients who had malignant ascites during the time octreotide was used and whose ascites could be evaluated by computed tomography before and after octreotide was started. Evaluation of ascites was classified into five levels of obviously decreasing, slightly decreasing, no change, slightly increasing, and obviously increasing. Results: Forty-nine patients used octreotide during the same period. Seven of these 49 patients met the eligibility criteria. The level of ascites was not classified as obviously decreasing or slightly decreasing in any of the patients. One patient was classified as no change. The other six were all slightly increasing or obviously increasing. Conclusion: In this study octreotide was not shown to be usuful for malignant ascites.

To improve the quality of palliative care in the Kyoto region, we thought that closely connecting hospice and palliative care units (PCU) is necessary. Subsequently, we established the Kyoto PCU Liaison Committee in September 2017. This committee was created as a place to casually discuss the problems that individual PCU facilities have, deliberate on their worries together, grow and develop, and support newly launched facilities. Furthermore, discussions were held on current topics (emergency hospitalization, blood transfusion, smoking, bereaved family meetings, etc.) at the liaison meetings. While meetings were adjourned in 2020 due to the COVID-19 pandemic, we continued to exchange opinions on infection control, PCU management, etc., using the email network at first. Later, these meetings resumed via web conference systems. Thus, by having face-to-face relationships on a daily basis, we were able to maintain cooperation between PCUs even during the pandemic, and collaborate with cancer treatment hospitals. Overall, by forming a team of PCUs in Kyoto Prefecture, we aim to enable patients and their families to live with peace of mind wherever they are.