Automated low flow pump system for the treatment of refractory ascites: a single-center experience
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Automated low flow pump system for the treatment of refractory ascites: a single-center experience. / Thomas, M N; Sauter, G H; Gerbes, A L; Stangl, M; Schiergens, T S; Angele, M; Werner, J; Guba, M.
In: LANGENBECK ARCH SURG, Vol. 400, No. 8, 12.2015, p. 979-83.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Automated low flow pump system for the treatment of refractory ascites: a single-center experience
AU - Thomas, M N
AU - Sauter, G H
AU - Gerbes, A L
AU - Stangl, M
AU - Schiergens, T S
AU - Angele, M
AU - Werner, J
AU - Guba, M
PY - 2015/12
Y1 - 2015/12
N2 - INTRODUCTION: Ascites is a common complication of liver cirrhosis and represents the main cause of hospitalization among patients with cirrhosis. First-line therapy for those patients is the use of diuretics and dietary sodium restriction. However, 10 % of patients per year become therapy refractory to diuretic treatment with the need of repeated high-volume paracentesis or transjugular intrahepatic portosystemic shunt (TIPS). For these patients, an automated pump system (Alfapump/Sequana Medical) was developed. Here, we describe our single-center experience of ten consecutively implanted pump systems.PATIENTS AND METHODS: Between 08/13 and 11/14, ten Alfapump systems were implanted in patients with refractory ascites all suffering from liver cirrhosis. Those patients were treated as a bridge to transplant (4/10) or as an end-stage therapy (6/10). Median follow-up was 165 days (23-379 days).RESULTS: Postimplant, the need of paracentesis could be markedly reduced to a mean of 0.45 (0-4/month) per month. In eight patients, paracentesis was not needed after implantation of the pump system. The median daily output volume was 1000 ml/day (450-2000 ml/day). Prerenal insufficiency was a recurrent complication in the postoperative period.DISCUSSION: The Alfapump system is a useful system in the treatment of patients suffering from therapy refractory ascites. However, due to the high level of comorbidities, careful patient selection and postoperative monitoring are required.
AB - INTRODUCTION: Ascites is a common complication of liver cirrhosis and represents the main cause of hospitalization among patients with cirrhosis. First-line therapy for those patients is the use of diuretics and dietary sodium restriction. However, 10 % of patients per year become therapy refractory to diuretic treatment with the need of repeated high-volume paracentesis or transjugular intrahepatic portosystemic shunt (TIPS). For these patients, an automated pump system (Alfapump/Sequana Medical) was developed. Here, we describe our single-center experience of ten consecutively implanted pump systems.PATIENTS AND METHODS: Between 08/13 and 11/14, ten Alfapump systems were implanted in patients with refractory ascites all suffering from liver cirrhosis. Those patients were treated as a bridge to transplant (4/10) or as an end-stage therapy (6/10). Median follow-up was 165 days (23-379 days).RESULTS: Postimplant, the need of paracentesis could be markedly reduced to a mean of 0.45 (0-4/month) per month. In eight patients, paracentesis was not needed after implantation of the pump system. The median daily output volume was 1000 ml/day (450-2000 ml/day). Prerenal insufficiency was a recurrent complication in the postoperative period.DISCUSSION: The Alfapump system is a useful system in the treatment of patients suffering from therapy refractory ascites. However, due to the high level of comorbidities, careful patient selection and postoperative monitoring are required.
KW - Ascites
KW - Female
KW - Humans
KW - Kidney Function Tests
KW - Length of Stay
KW - Liver Cirrhosis
KW - Liver Function Tests
KW - Male
KW - Operative Time
KW - Paracentesis
KW - Patient Selection
KW - Portasystemic Shunt, Transjugular Intrahepatic
KW - Postoperative Complications
KW - Prostheses and Implants
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1007/s00423-015-1356-1
DO - 10.1007/s00423-015-1356-1
M3 - SCORING: Journal article
C2 - 26566989
VL - 400
SP - 979
EP - 983
JO - LANGENBECK ARCH SURG
JF - LANGENBECK ARCH SURG
SN - 1435-2443
IS - 8
ER -