Radiological Tenckhoff catheter insertion for peritoneal dialysis: A cost-effective approach

Insertion of Tenckhoff catheters for continuous ambulatory peritoneal dialysis by nephrologists remains uncommon in most developing countries, including Indonesia. The aim of this study is to describe our experience on a simple technique of Tenckhoff catheter insertion by a nephrologist called the Bandung method. We conducted a retrospective observational study from May 2012 until December 2018 in 230 patients with end-stage renal disease using the Bandung method, a blind percutaneous insertion approach modified from the Seldinger technique. Early complications after insertion were assessed. The mean age of patients was 47.28 years (range 14–84 years). Within 1 month after insertion, complications occurred in 34 patients: 13 (5.7%) malposition, 8 (3.5%) omental trapping, 6 (2.6%) outlow failure, 3 (1.3%) peritonitis, 1 (0.4%) catheter infections, 1 (0.4%) bleeding, 1 (0.4%) kinking, and 1 (0.4%) hernia. None of these complications led to catheter removal. One patient experienced a late (>1 month) post-insertion complication of malposition that could not be repositioned and led to catheter removal. The Bandung method is a simple, cost effective, and minimally invasive technique for Tenckhoff catheter insertion that is associated with the same rate of complications compared to other techniques. This technique may useful for application in developing countries.

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Infection Prophylaxis in Peritoneal Dialysis Patients: Results from an Australia/New Zealand Survey

Peritoneal Dialysis International ◽

10.3747/pdi.2016.00037 ◽

2017 ◽

Vol 37 (2) ◽

pp. 191-197 ◽

Cited By ~ 4

Author(s):

Denise J. Campbell ◽

David W. Mudge ◽

Martin P. Gallagher ◽

Wai Hon Lim ◽

Dwaraka Ranganathan ◽

...

Keyword(s):

Peritoneal Dialysis ◽

New Zealand ◽

Antifungal Prophylaxis ◽

Catheter Insertion ◽

Infection Prophylaxis ◽

Infection Rates ◽

Clinical Practices ◽

Tenckhoff Catheter ◽

Mupirocin Ointment ◽

End Stage

BackgroundClinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients.MethodsA survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013.ResultsOf 333 nephrologists approached, 133 (39.9%) participated. Overall, 127 (95.5%) nephrologists prescribed antibiotics at the time of Tenckhoff catheter insertion, 85 (63.9%) routinely screened for nasal S. aureus carriage, with 76 (88.4%) reporting they treated S. aureus carriers with mupirocin ointment. Following Tenckhoff catheter insertion, 79 (59.4%) prescribed mupirocin ointment at the exit site or intranasally, and 93 (69.9%) nephrologists routinely prescribed a course of oral antifungal agent whenever their PD patients were given a course of antibiotics.ConclusionsAlthough the majority of nephrologists prescribe antibiotics at the time of Tenckhoff catheter insertion, less than 70% routinely prescribe mupirocin ointment and/or prophylactic antifungal therapy. This variation in practice in Australia and New Zealand may contribute to the disparity in PD-related infection rates that is seen between units.

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Urgent-Start Peritoneal Dialysis: A Comparison of Catheter Insertion Using Seldinger Technique and Surgical Operation

International Journal of Nephrology and Kidney Failure ◽

10.16966/2380-5498.220 ◽

2021 ◽

Vol 7 (4) ◽

Author(s):

Yu C ◽

Yang N ◽

Wang K ◽

Lin H ◽

Li L

Keyword(s):

Peritoneal Dialysis ◽

Cost Effective ◽

Catheter Insertion ◽

Seldinger Technique ◽

Operation Technique ◽

Surgical Operation ◽

Percutaneous Catheter ◽

Cost Effective Method ◽

Operative Complications ◽

Insertion Techniques

Background: Urgent-Start Peritoneal Dialysis (USPD) is increasingly used worldwide and represents a safe, convenient and cost-effective method to initiate dialysis. However, good catheter insertion techniques are imperative to avoid postoperative complications. While percutaneous catheter insertion by Seldinger technique is considered a safe method with few post-operative complications, comparisons with surgical operation technique are needed, especially in China, where there a few reports on the outcome of percutaneous catheter insertion by Seldinger technique in USPD patients.

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Mini-Laparotomy Implantation of Peritoneal Dialysis Catheters: Outcome and Rescue

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00033 ◽

2010 ◽

Vol 30 (5) ◽

pp. 513-518 ◽

Cited By ~ 19

Author(s):

Po-Jen Yang ◽

Chih-Yuan Lee ◽

Chi-Chuan Yeh ◽

Hsiao-Ching Nien ◽

Tun-Jun Tsai ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Laparoscopic Surgery ◽

Postoperative Care ◽

Catheter Insertion ◽

Exit Site ◽

Tenckhoff Catheter ◽

Experienced Surgeon ◽

Catheter Obstruction ◽

Surgical Methods ◽

Mini Laparotomy

BackgroundContinuous ambulatory peritoneal dialysis is one of the main treatments for end-stage renal disease. To correct mechanical outflow obstruction after open surgical methods of catheter insertion, laparoscopic techniques are widely employed.MethodsBetween January 2001 and December 2006, 228 open Tenckhoff catheter implantations were carried out by mini-laparotomy in 218 patients at our medical center. The procedures were all performed by an experienced surgeon, and the postoperative care, patient education, and long-term follow-up were all conducted by the same peritoneal dialysis team.ResultsInfection of the exit site or tunnel was the most common complication (27/228, 11.8%), followed by peritonitis (18/228, 7.9%) and refractory mechanical catheter obstruction (9/228, 3.9%). The main causes of catheter removal were successful renal transplantation (21/228, 9.2%), peritonitis (18/228, 7.9%), and infection of the exit site or tunnel (7/228, 3.1%). In the 9 cases of refractory mechanical catheter obstruction, laparoscopic surgery was performed to identify the pathology and to rescue the catheter at the same time. Omental wrapping was the major cause (8/9) of catheter obstruction, with blood clot in the lumen and tube migration occurring in the remaining case (1/9). Partial omentectomy was performed in 5 patients to prevent recurrent obstruction. Neither technique failure nor operation-related complications were noted in our laparoscopic rescue group. For 20 of the 25 patients with refractory infection of the exit site or tunnel, the salvage technique of partial re-plantation was performed, with an 85% (17/20) technique survival rate.ConclusionsWith an experienced surgeon and a good postoperative care team, open paramedian placement is a simple, safe, and effective method for Tenckhoff catheter insertion, with a low complication rate. Laparoscopic surgery is effective as rescue for mechanical obstruction, and partial re-plantation is effective as salvage for exit-site or tunnel infection.

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Catheter Break-in for Continuous Ambulatory Peritoneal Dialysisuniversity of Missouri Experience

Peritoneal Dialysis International ◽

10.1177/089686088400402s11 ◽

1984 ◽

Vol 4 (2_suppl) ◽

pp. 110-111 ◽

Cited By ~ 2

Author(s):

J. Zbylut ◽

Twardowski Leonor ◽

P. Ryan ◽

Juanita M. Kennedy

Keyword(s):

Peritoneal Dialysis ◽

Surgical Technique ◽

Retrospective Analysis ◽

Outpatient Clinic ◽

Small Volume ◽

Catheter Insertion ◽

Surgical Correction ◽

Tenckhoff Catheter ◽

Uremic Patients ◽

Clinic Visits

Retrospective analysis of the results of several break-in techniques in our institution revealed that a 10 day delay in CAPD initiation after a midline Tenckhoff catheter insertion is sufficient to prevent leakage in patients maintained on intermittent peritoneal dialysis. A leak or obstruction related to an insufficient surgical technique can be promptly diagnosed and corrected. An irrigation technique seems to be useful in non-uremic patients, but frequently fails to disclose a one-way obstruction with a consequent delay in a surgical correction. Recently we have introduced a modification of this technique in which the patency of the catheter is checked with one in and out exchange using a small volume of dialysate during outpatient clinic visits every 2– 3 days.

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CLINICAL EVALUATION OF TENCKHOFF CATHETER INSERTION IN PAEDIATRIC PERITONEAL DIALYSIS : A SINGLE CENTER STUDY

Indonesian Journal of Urology ◽

10.32421/juri.v28i2.682 ◽

2021 ◽

Vol 28 (2) ◽

pp. 153-157

Author(s):

Syahdat Nurkholiq ◽

Tanaya Ghinorawa

Keyword(s):

Renal Failure ◽

Peritoneal Dialysis ◽

General Hospital ◽

Kidney Failure ◽

Open Surgery ◽

Chronic Kidney Failure ◽

Catheter Insertion ◽

Common Cause ◽

Tenckhoff Catheter ◽

Catheter Dysfunction

Objective: This study aimed to evaluate the clinical outcome of Tenckhoff catheter insertion at Sardjito General Hospital for pediatric renal failure. Material & Methods: Data were collected from January 2014 to December 2018 at Sardjito General Hospital. All patient records were collected retrospectively such as patient characteristics, underlying diseases of kidney failure, congenital abnormalities, surgical technique, complications that occur after Tenckhoff catheter insertion. Results: 45 patients meet the inclusion criteria. A total of 7 patients with acute kidney failure (15.5%) and 38 patients with chronic kidney failure (84.5%). Glomerulonephritis is the most common cause of kidney failure (21 patients, 46.7%). The insertion technique used was open surgery in 34 patients (76%) and laparoscopic insertion in 11 patients (24%). Complications reported were catheter dysfunction, leakage of dialysate, surgical site infection, and peritonitis. Conclusion: Tenckhoff catheter insertion for peritoneal dialysis (PD) in pediatric patients with acute and chronic renal failure performed in our center is effective and safe. The most common cause of renal failure in pediatric is glomerulonephritis. Open surgery and laparoscopic insertion of Tenckhoff catheter both have a low complication rate. Catheter dysfunction due to mechanical catheter obstruction is one of the main problems in the placement of Tenckhoff catheter.

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Equilibrium Peritoneal Dialysis (EPD) in Acute Renal Failure (ARF) Secondary to Rhabdiomyolysis

Peritoneal Dialysis International ◽

10.1177/089686088700700409 ◽

1987 ◽

Vol 7 (4) ◽

pp. 244-246 ◽

Cited By ~ 5

Author(s):

Alejandro Trevino-Becerra ◽

Patricia Munoz Cristina A vilez ◽

Ma. Antonieta Schetino Maimone ◽

Ma. Luisa Erbessd Lopez

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Peritoneal Dialysis ◽

Catheter Insertion ◽

Urinary Volume ◽

Tenckhoff Catheter ◽

Adequate Method

The purpose of this work is to assess EPD in ARF patients who have suffered rhabdomyolysis. In preparation for Tenckhoff catheter insertion dialysis exchanges through a stylet catheter were used every 30 minutes; after implantation of the Tenckhoff catheter we started 2L of solution with six four-hour exchanges. Dialysis was discontinued after 16 days on average when patients had a urinary volume of over one litre in 24 hours. Results allow us to conclude that EPD is an adequate method of treatment for ARF due to rhabdomyolysis.

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