A Single-Center Experience: The Diagnostic Role of Peritoneoscopy in Patients with Exudative Ascites

Our plain-English summary of A Single-Center Experience: The Diagnostic Role of Peritoneoscopy in Patients with Exudative Ascites, by B. Abaylı, G. Gençdal (Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a, 2019).

The study

• Authors: B. Abaylı, G. Gençdal
• Journal: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
• Published: 2019;29(1):51-54
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background And Aim: The causes of exudative and transudative ascites can be detected through noninvasive methods nowadays. In selected cases, peritoneoscopy could be necessary for definitive diagnosis. In this retrospective study, we aimed to present the peritoneal biopsy results of patients who had exudative ascites with unclear etiology.

Materials And Methods: A retrospective analysis was performed in 86 patients who had exudative ascites of unclear etiology. All the patients showed abnormalities of the peritoneum or greater omentum as determined by abdominal ultrasonography and underwent peritoneoscopy between January 2012 and December 2015. Patient data were obtained from hospital records.

Results: Eighty-six patients (male: 22; 25.6%, mean age ± standard deviation: 57.97 ± 15.97) who had exudative ascites of unclear etiology were included to the study. The success rate of the procedures was 100% (86/86). A specific histopathological diagnosis was made in all patients, with an overall diagnostic accuracy of 100%. Among the 86 diagnosed patients, 43 (50%) were peritonitis carcinomatosa, 21 (24.4%) were tuberculous peritonitis, 14 (16.3%) were mesothelioma, 4 (4.7%) were chronical inflammation, and 1 (1.2%) was lymphoma. Three (3.5%) patients had normal peritoneal biopsy findings.

Discussion: Peritoneoscopy is a safe and efficient alternative method due to its high diagnostic capacity in selected patients who have exudative ascites of unclear etiology.

In plain English

This was a retrospective study from Turkey. It reviewed hospital records of 86 patients who had exudative ascites (a protein-rich build-up of fluid in the abdomen) of unclear cause, and whose ultrasound showed abnormalities of the peritoneum or greater omentum. Between January 2012 and December 2015, all of them underwent peritoneoscopy, a camera examination of the abdomen with biopsy, done under sedation in an endoscopy unit. Of the 86 patients, 22 (25.6%) were men, and the mean age was 57.97 years. The authors reported that the procedure succeeded in all 86 patients. Biopsies showed peritonitis carcinomatosa (cancer spread to the abdominal lining) in 43 patients (50%), tuberculous peritonitis in 21 (24.4%), mesothelioma in 14 (16.3%), chronic inflammation in 4 (4.7%) and lymphoma in 1 (1.2%). Three patients (3.5%) had normal biopsy findings. The article does not describe the mesothelioma cases further and does not mention asbestos. The authors concluded that peritoneoscopic biopsy is still efficient in selected patients with exudative ascites of uncertain cause. They named the study's retrospective design as its main limitation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of hospital records (single-center case series)
• Who was studied: 86 patients with exudative ascites of unclear cause and abnormalities of the peritoneum or greater omentum on ultrasound, who underwent peritoneoscopy between January 2012 and December 2015 in Turkey; 22 (25.6%) were men; mean age 57.97 years (standard deviation 15.97)
• Exposure: No asbestos or other environmental or occupational exposure was studied. The study examined a diagnostic procedure: peritoneoscopy with biopsy, performed under sedation in an endoscopy unit.
• Main results:
  • The procedure was successful in all 86 patients (100%).
  • Among the 86 patients, biopsy diagnoses were peritonitis carcinomatosa in 43 (50%), tuberculous peritonitis in 21 (24.4%), mesothelioma in 14 (16.3%), chronic inflammation in 4 (4.7%) and lymphoma in 1 (1.2%).
  • Three of the 86 patients (3.5%) had normal peritoneal biopsy findings.
  • Among the 43 patients with peritonitis carcinomatosa, the primary cancer site was the ovary in 18, pancreas in 7, stomach in 6, colon in 4 and hepatocellular cancer in 2. In 6 patients the primary site was unclear. The printed percentages are of all 86 patients.
  • Adenosine deaminase (ADA) and Ca-125 levels were high in patients with tuberculous peritonitis, but no statistically significant difference was found between groups.
• The authors' conclusion: The authors concluded that peritoneoscopic biopsy is still efficient in selected patients with exudative ascites of uncertain cause.
• Limitations the authors state:
  • The authors stated that the retrospective design was the study's main limitation.

Topics

Medical terms in this study, explained in our Lexicon: Ascites, Biopsy, Etiology, Peritoneum, Omentum, Mesothelioma, Inflammation.

Related studies

• The role of "closed abdomen" hyperthermic intraperitoneal chemotherapy (HIPEC) in the palliative treatment of neoplastic ascites from peritoneal carcinomatosis: report of a single-center experience — L. Orgiano, F. Pani, et al. (2016)
• Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites — C. Bera, J.S. Michael, et al. (2015)
• Detection of Anaplastic Lymphoma Kinase-Rearranged Mesothelioma Cells in Ascites by Companion Diagnostics — M. Konishi, T. Kanyama, et al. (2020)
• The role of peritoneal biopsy in the diagnosis of ascites — P.F. Jenkins, M.J. Ward (1980)
• Metastatic peritoneal mesothelioma in the setting of recurrent ascites: a case report — V. Samedi, S. White, et al. (2010)
• Challenging and uncommon diagnosis of long-evolution ascites — M. Gravito-Soares, E. Gravito-Soares, et al. (2017)

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