scholarly journals How to Prevent Peritoneal Dialysis Catheter Tip Migration: A Japanese Perspective

2021 ◽  
Vol 1 (1) ◽  
pp. 29-34
Author(s):  
Minoru Ito ◽  
Masataka Koshika
Keyword(s):  
Peritoneal Dialysis ◽  
Successful Outcome ◽  
Peritoneal Dialysis Catheter ◽  
Common Complication ◽  
Type Selection ◽  
Catheter Malfunction ◽  
Peritoneal Wall ◽  
Catheter Tip ◽  
Catheter Complications ◽  
Japanese Perspective

The prevention of peritoneal dialysis (PD) catheter complications is essential to achieve a successful outcome. In recent years, nephrologists have performed more PD catheter insertion surgeries in Japan. The prevention of catheter complications is crucial for nephrologists who do not have all-around surgical skills. PD catheter tip migration is a common complication and a significant cause of catheter malfunction. Several preventive techniques have been reported for the PD catheter tip migration. This perspective described the following: (1) surgical technique in laparotomy, (2) laparoscopic surgery, (3) peritoneal wall anchor technique, and (4) catheter type selection. We hope that more effective methods of preventing catheter complications will be developed to ensure the success of PD treatment.

Laparoscopic Findings of Peritoneal Dialysis Catheter Malfunction and Management Outcomes

2006 ◽  
Vol 26 (3) ◽  
pp. 374-379 ◽  
Author(s):  
Tuncay Yilmazlar ◽  
Turkay Kirdak ◽  
Serpil Bilgin ◽  
Mahmut Yavuz ◽  
Mustafa Yurtkuran
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Tertiary Referral ◽  
Catheter Survival ◽  
Tertiary Referral Center ◽  
Catheter Malfunction ◽  
Catheter Tip ◽  
Effective Procedures ◽  
Laparoscopic Finding

Objective Peritoneal dialysis catheter malfunction is a common complication forcing conversion to hemodialysis. The purpose of this study was to evaluate laparoscopic findings of catheter malfunction and to establish a relationship between those findings and the outcomes of procedures performed. Design Retrospective study. Setting A tertiary referral center. Patients 40 consecutive patients with stage 5 chronic kidney disease underwent 46 laparoscopic correction procedures for the treatment of peritoneal dialysis catheter malfunction between November 1994 and August 2004. Main Outcome Measures Laparoscopic findings of catheter malfunction, procedures performed, catheter survival, and recurrent cases were evaluated. Results There were 28 tip migrations in 40 patients; 16 were without adhesions and 10 were associated with omental adhesions. Reposition and adhesiolysis were the most frequent procedures performed. Malfunction recurred in 12 patients and 5 of them underwent 6 secondary laparoscopic procedures. Estimated mean catheter survival was 19.9 ± 3.32 months (%95 confidence interval 13.43 – 26.46). Conclusions The most frequent laparoscopic finding was catheter tip migration, with or without adhesions. Laparoscopic repositioning and adhesiolysis without omentectomy are simple and effective procedures that can prolong catheter survival, even in recurrent malfunctions.

scholarly journals A gripping case of peritoneal dialysis catheter malfunction

2015 ◽  
Vol 87 (2) ◽  
pp. 483 ◽  
Author(s):  
Peter A.G. Doubel ◽  
Franky P. Vansteenkiste ◽  
Olivier P. Schockaert
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Malfunction

scholarly journals A Technique to Address Peritoneal Dialysis Catheter Malfunction

2010 ◽  
Vol 14 (4) ◽  
pp. 608-610 ◽  
Author(s):  
Chee-Chee H. Stucky ◽  
Mark C. Mason ◽  
James A. Madura ◽  
Kristi L. Harold
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Malfunction

Practice of Peritoneal Dialysis Catheter Flushing in Australia and New Zealand: Multi-Center Cross-Sectional Survey

2017 ◽  
Vol 38 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Yeoungjee Cho ◽  
Neil Boudville ◽  
Suetonia C. Palmer ◽  
Josephine S.F. Chow ◽  
Carmel M. Hawley ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
New Zealand ◽  
Clinical Care ◽  
Peritoneal Dialysis Catheter ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Catheter Obstruction ◽  
Catheter Malfunction ◽  
On Line

Background Evidence of effective interventions to prevent peritoneal dialysis (PD) catheter malfunction before first use is presently insufficient to guide clinical care. Regular flushing of the PD catheter (e.g. before PD commencement) has been adopted by some practitioners in the belief that it will prevent catheter obstruction and/or malfunction. The aim of this study was to characterize and evaluate PD catheter flushing practices across Australian and New Zealand PD units. Methods An on-line survey was distributed to all 62 PD units in Australia (12 August 2016; n = 51) and New Zealand (2 February 2017; n = 11), with questions relating to PD catheter flushing practices, audit, and outcomes. Results Forty-nine units of variable size (< 16 to > 100 patients) completed the survey (79% response rate). All centers flushed PD catheters at some stage after insertion as routine unit practice. Forty-one units (84%) routinely flushed during periods of PD rest at varying intervals ranging from alternate daily to monthly. The type and volume of solution used to flush varied between units. Units that practised routine flushing of PD catheters were almost twice as likely to audit their catheter-related outcomes (66% vs 38%, p = 0.23) and more likely to have reported blocked catheters in the preceding 12 months (84% vs 0%, p = 0.01) compared with those units that did not routinely flush PD catheters. Thirty units (61%) regularly audited and monitored catheter-related outcomes. Conclusions This study identified a wide variation in center practices relating to PD catheter flushing. Drawing conclusions about any relationship between flushing practices and clinical outcomes was impeded by the relatively low uptake of regular auditing and monitoring of catheter-related outcomes across surveyed units. Evaluation of the benefits and harms of standardized PD catheter flushing practices on patient outcomes in a randomized trial is needed to guide practice.

The Need for a “Swan Neck” Permanentl Y Bent, Arcuate Peritoneal Dialysis Catheter

1985 ◽  
Vol 5 (4) ◽  
pp. 219-223 ◽  
Author(s):  
Zbylut J. Twardowski ◽  
Karl D. Nolph ◽  
Ramesh Khanna ◽  
Barbara F. Prowant ◽  
Leonor P. Ryan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Complication Rate ◽  
Rectus Muscle ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Exit Site ◽  
The Past ◽  
Optimal Function ◽  
Catheter Tip ◽  
Subcutaneous Tunnel

In 1968 to ensure optimal function of a permanent catheter during periodic peritoneal dialysis, Tenckhoff recommended that a double-cuff catheter be inserted so that a slightly arcuate subcutaneous course would give the external and intraperitoneal segment a caudal direction. During the rapid growth of CAPD over the past five years, nephrologists generally have adapted the Tenckhoff's methods of catheter insertion but have encountered numerous complications. This paper describes a retrospective analysis of the complications associated with 83 peritoneal dialysis catheters functioned for 48,325 catheter days (132 catheter years) in 63 patients on continuous ambulatory peritoneal dialysis (CAPD) at our institution. Pericatheter leaks were seen only with midline insertions. Exit-site infections were significantly more resistant to treatment with singlecuff than with double-cuff catheters as assessed by the proportion of time that the exit-site is infected. If the subcutaneous tunnels were directed downward the infections were more responsive to treatment. Significantly more frequent catheter-tip migrations were observed with subcutaneous tunnel directed left and downward. Thus, our study supports Tenckhoff's observation that we can expect the lowest complication rate with double-cuff catheters with an arcuate tunnel, convex upwards. However, frequently this shape of tunnel is associated with external-cuff extrusions due to resilience of the straight catheter. To reconcile these conflicting requirements we recommend a new catheter permanently bent between the cuffs to eliminate one of the forces responsible for cuff extrusion. Such a catheter, named the swan-neck tunnel peritoneal dialysis catheter, should be inserted surgically through the belly of the rectus muscle.

A Simple Method to Prevent Peritoneal Dialysis Catheter Tip Migration

2007 ◽  
Vol 27 (5) ◽  
pp. 554-556 ◽  
Author(s):  
Wen-Ming Chen ◽  
Chen-Li Cheng
Keyword(s):  
Peritoneal Dialysis ◽  
Wound Care ◽  
Fixation Method ◽  
Peritoneal Dialysis Catheter ◽  
Simple Method ◽  
Exit Site Infection ◽  
Tenckhoff Catheter ◽  
Catheter Tip ◽  
Stage Renal Disease

Background We report here a one-stitch fixation method that prevents catheter tip migration during implantation of the double-cuffed straight Tenckhoff catheter. Methods From July 2003 to September 2005, 38 patients with end-stage renal disease underwent implantation of the double-cuff straight Tenckhoff catheter for peritoneal dialysis by this method. Results No patient had catheter tip migration out of the true pelvis. No patient had pericatheter dialysate leakage or developed incisional hernia. Two patients (5.3%) experienced exit-site infection during the 2- and 5-month follow-up and they recovered well after wound care. Three patients (7.9%) developed peritonitis during the 3-day and 2- and 6-month follow-up; the conditions were controlled after antibiotic care. One patient (2.6%) experienced mechanical catheter obstruction during the 10-day follow-up due to omental wrapping; surgical revision was necessitated. Conclusions We believe that the method is an easy, safe, and effective technique for preventing catheter tip migration.

scholarly journals Minilaparotomy Salvage of Malfunctioning Catheters in Peritoneal Dialysis

2013 ◽  
Vol 33 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Jian-ri Li ◽  
Chi-hung Cheng ◽  
Kun-yuan Chiu ◽  
Chen-li Cheng ◽  
Chi-rei Yang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Clot ◽  
Operating Time ◽  
Onset Time ◽  
Entry Site ◽  
Significant Complication ◽  
Catheter Malfunction ◽  
Catheter Tip ◽  
The Mean ◽  
Peritoneal Entry

♦BackgroundCatheter malfunction is a common and significant complication during peritoneal dialysis (PD). We developed a minilaparotomy procedure to rescue malfunctioning catheters and to prevent recurrence of malfunction.♦MethodsFrom 2006 to 2011, 11 patients receiving PD had a malfunctioning catheter. In all patients, a 2-cm incision, 5 cm caudally to the previous peritoneal entry site was used to correct the malfunctioning catheter, with concomitant fixation of the catheter to the peritoneum.♦ResultsCatheter tip migration occurred in 7 patients, omental wrapping in 3, and blood clot obstruction in 1. The mean onset time to catheter malfunction was 197.5 days (range: 4 – 1270 days), and the mean operating time was 41 minutes (range: 35 – 56 minutes). There was no recurrence of catheter malfunction and no surgery-related peritonitis.♦ConclusionsOur minilaparotomy procedure is safe and feasible for the salvage of malfunctioning PD catheters.

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