Paracentesis is a minimally-invasive procedure used to remove excess fluid from the abdominal cavity, a condition also called ascites. This procedure may also be an abdominal or ascites tap, and may be used for either diagnostic or therapeutic reasons. This excess fluid tends to collect in patients with peritoneal mesothelioma, which affects the membrane that lines the abdominal cavity.
A small amount of fluid is normal to prevent friction between the organs and other structures in the abdomen, but when too much collects, it can cause pressure and discomfort. It can also negatively affect a patient’s ability to breathe, interfering with the normal function of the intestines or stomach. Paracentesis removes the excess fluid to help reduce or eliminate pressure buildup and relieve symptoms so mesothelioma patients experience an improved quality of life. The procedure is also used to help relieve fluid buildup that occurs for other conditions, including other types of cancer, infections or liver disease.
The Paracentesis Procedure
Paracentesis uses a long, hollow needle or tube to access the excess fluid in the abdominal cavity so it can be removed. Before the procedure, the needle insertion site will be carefully cleaned and numbed with a local anesthetic. The needle will be carefully placed into the abdominal cavity at the site of fluid buildup. The needle may be guided by a CT scan or ultrasound to ensure it’s in the proper location. After the needle reaches the treatment site, the fluid will be gently extracted.
Patients may feel a slight pulling sensation as the needle is inserted and the fluid is removed. Patients may also experience lightheadedness, and should let the doctor know they start to feel sick or unwell during the procedure. Once the fluid is extracted, the needle will be removed and a bandage will be placed over the injection site. The procedure can be performed right in the doctor’s office, in a medical center or imaging center, or in a hospital.
Patients may have some drainage from the site for a day or two, especially if a lot of fluid is removed during the procedure. They may also need to take part in multiple sessions, since fluid buildup may return.
Once the fluid is removed, patients generally experience a relief from symptoms, including:
- Being able to breath more comfortably
- Reduced sensation of fullness or pressure in stomach
Risks and Complications
Paracentesis is generally considered to be a safe procedure, but as with any type of medical procedure, there are risks that should be considered prior to undergoing treatment, including:
- Perforation (puncturing) of the bowel, bladder or a blood vessel
- Transfer of cancer cells from one area of the abdomen to another
- Shock, especially if a very large amount of fluid is removed causing your blood pressure to rapidly drop
- Kidney malfunction, especially in those with kidney disease or risk factors for kidney disease
- Bleeding and infection
If you have questions about paracentesis or other procedures used in the management of mesothelioma, speak with your doctor.