scholarly journals Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

2019 ◽  
Author(s):  
Dayang Xie ◽  
Jianhui Zhou ◽  
Xueying Cao ◽  
Qingtao Zhang ◽  
Yanli Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
One Year ◽  
The One

Abstract Background A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion, although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

scholarly journals Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

2020 ◽  
Author(s):  
Dayang Xie ◽  
Jianhui Zhou ◽  
Xueying Cao ◽  
Qingtao Zhang ◽  
Yanli Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
One Year ◽  
The One

Abstract Background. A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion , although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods. 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results. Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions. Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

Comparison of Straight and Curled Tenckhoff Peritoneal Dialysis Catheters Implanted by Percutaneous Technique: A Prospective Randomized Study

1995 ◽  
Vol 15 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Palle K. Nielsen ◽  
Claus Hemmingsen ◽  
Steffen U. Friis ◽  
Jorgen Ladefoged ◽  
Klaus Olgaard
Keyword(s):  
Peritoneal Dialysis ◽  
Randomized Study ◽  
Infectious Complications ◽  
University Hospital ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
The Impact

Objective To examine the impact of peritoneal dialysis catheter configuration, curled or straight catheter, on catheter survival and mechanical and infectious complications. Design Prospective randomized trial. Setting Department of Nephrology of a single university hospital. Patients Seventy-two consecutive patients initiating peritoneal dialysis were randomized to receive either a single cuff straight catheter or a single cuff curled catheter, implanted by percutaneous technique. Results Significantly higher (p < 0.01) survival rate of the curled as compared to the straight catheter. The difference in catheter survival was due to a significantly higher (p < 0.01) incidence of drainage failure associated with catheter tip migration of the straight catheter than of the curled catheter. No difference in infectious complication between the two types of catheters was seen. Catheter survival at 12 months was 77% for the curled catheter and 36% for the straight catheter. Conclusion This study demonstrates superiority of the curled Tenckhoff peritoneal dialysis catheter survival as compared to the straight catheter. This difference in catheter survival is due to the higher displacement rate of the straight catheter.

Randomized Prospective Comparison of Laparoscopic and Open Peritoneal Dialysis Catheter Insertion

1999 ◽  
Vol 19 (4) ◽  
pp. 372-375 ◽  
Author(s):  
Mark J. Wright ◽  
Khalid Bel'eed ◽  
Brian F. Johnson ◽  
David W. Eadington ◽  
Leslie Sellars ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Renal Unit ◽  
Complication Rates ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival ◽  
Conventional Procedure ◽  
Prospective Comparison ◽  
Duration Of Surgery

Objective To compare laparoscopic and conventional peritoneal dialysis catheter insertion with respect to post operative discomfort, complication rates, and catheter survival. Design Randomized prospective study. Setting Tertiary referral renal unit. Patients Fifty patients commencing peritoneal dialysis. Intervention Catheters were implanted laparoscopically or by a conventional surgical technique. Main Outcome Measures The duration of surgery, hospital stay, pain scores, and analgesic requirements were recorded. Complications (early/late) and catheter survival were compared. Results The conventional procedure was faster than the laparoscopic (14.3 vs 21.9 minutes, p < 0.0001). There was no difference in any other parameter assessed. Conclusions The data suggest that the insertion techniques are equivalent, and that laparoscopic insertion does not reduce early complication rates.

scholarly journals Percutaneous insertion of peritoneal dialysis catheters by the nephrologist (modified Seldinger technique)

2021 ◽  
Vol 4 (4) ◽  
pp. 277-288
Author(s):  
Karlien Francois ◽  
Dieter De Clerck ◽  
Tom Robberechts ◽  
Freya Van Hulle ◽  
Stefan Van Cauwelaert ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
Catheter Insertion ◽  
Seldinger Technique ◽  
Prior History ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival ◽  
Set Up ◽  
Percutaneous Insertion

A proper functioning access to the peritoneal cavity is the first and foremost requirement to start peritoneal dialysis. Most commonly, peritoneal dialysis catheters are inserted using a surgical approach. Laparoscopic peritoneal dialysis catheter insertion is the recommended surgical technique because it offers to employ advanced adjunctive procedures that minimize the risk of mechanical complications. In patients with low risk of mechanical catheter complications, such as patients without prior history of abdominal surgery or peritonitis, and in patients ineligible for general anesthesia, the percutaneous approach of peritoneal dialysis catheter insertion is an alternative to surgical catheter insertion. Percutaneous insertion of peritoneal dialysis catheters can be performed by a dedicated nephrologist, interventional radiologist, surgeon or nurse practitioner under local anesthesia, either with or without image guidance using ultrasound or fluoroscopy. Several reports show similar catheter function rates, mechanical and infectious complications and catheter survival for percutaneously inserted peritoneal dialysis catheters compared to surgically inserted peritoneal dialysis catheters. This article describes the percutaneous insertion of peritoneal dialysis catheters technique adopted at Universitair Ziekenhuis Brussel since 2015. Our technique is a simple low-tech modified Seldinger procedure performed by the nephrologist and not using fluoroscopy guidance. We describe the excellent outcomes of our percutaneously inserted peritoneal dialysis catheters and offer a practical guide to set up your own percutaneous catheter insertion program.

scholarly journals Selective Infracolic Omentecomy and Fixation Reduces Complications after Laparoscopic Assisted Peritoneal Dialysis Catheter Placement

2018 ◽  
Vol I (1) ◽  
pp. 06-11
Author(s):  
Andries Ryckx
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Placement ◽  
P Value ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Exit Site ◽  
Exit Site Infection ◽  
Catheter Survival ◽  
Catheter Obstruction ◽  
Infracolic Omentectomy

Introduction Peritoneal dialysis (PD) as a treatment for patients with end-stage renal disease (ESRD) provides a competitive alternative to hemodialysis (HD). Long-term catheter survival remains challenging and techniques are not standardized. Advanced laparoscopic placement with fixation and omentectomy might increase catheter survival. The goal of our study was to evaluate if selective infracolic omentectomy and fixation reduced complications after CAPD catheter placement. Materials and Methods A prospective database of patients with CAPD catheter placement from March 2004 to March 2015 was analyzed. All procedures were performed laparoscopically assisted and under general anesthesia by a single surgeon. 78 patients were included, there were no exclusion criteria. Statistical analysis was performed with SPSS. Fisher exact test and log-rank test with calculation of P-value was executed. P-value of <0.05 was considered significant. Results Of the 78 patients who underwent catheter placement, 53 (68%) were males and 25 (32%) were females. The mean age was 54 (ranged from 13 to 88 years). Selective infracolic omentectomy was performed in 32 patients if the momentum reached beyond the promontory. Non-resorbable sutures to fix the catheter were applied in 33 patients. The average duration of peritoneal dialysis was 21 months (range from ten days to 84 months). Omentectomy significantly reduced the incidence of catheter obstruction (3 vs. 11%, P=0.028) but not of catheter dislocation (19 vs. 30%, P=0.101). Omentectomy did not significantly increase the incidence of peritonitis (22 vs. 31%,P=0.133) or exit-site infection (16vs 17%, P=0.238). Catheter fixation with non-resorbable sutures reduced catheter dislocation (21 vs. 23%, P=0.226) and catheter obstruction( 12 vs.17%,P=0.223) with a significant reduction of peritonitis (15 vs. 29%, P=0.044) and no effect on exit-site infection (15 vs. 17%,P=0.251). Conclusion Laparoscopic PD catheter placement with selective omentectomy and fixation of the catheter to the abdominal wall is safe and feasible and leads to fewer complications. Key words: peritoneal, dialysis, catheter, complications, laparoscopy, omentectomy.

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