HIGH MORTALITY AFTER ABDOMINAL OPERATION IN PATIENTS WITH LARGE-VOLUME MALIGNANT ASCITES

Advanced intra-abdominal cancers are frequently associated with malign ant ascites. The aim of this study was to document the frequency and c linical course of patients found to have large-volume (greater than or equal to 3 L) malignant ascites when undergoing a major abdominal ope ration. Between October 1, 1987 and September 1, 1992, 385 patients wi th malignant ascites were admitted to hospitals associated with a univ ersity medical center. Seventeen with large volume ascites underwent e xploration for palliation of bowel obstruction or debulking of tumor. Operative mortality was 41% and mortality correlated with the presence of a nonovarian primary and advanced age. We conclude that patients w ith large volume nonovarian malignant ascites have a high mortality ra te following a major abdominal operation. New approaches such as neoad juvant or intraperitoneal chemotherapy or possibly peritoneovenous shu nt placement at the time of the abdominal operation, are needed to imp rove the dismal results in this subgroup of patients. (C) 1996 Wiley-L iss, Inc.