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Modified Laparoscopic Technique for Fixation of Peritoneal Dialysis Catheter
- Source :
- Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 24:e146-e150
- Publication Year :
- 2014
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2014.
-
Abstract
- BACKGROUND Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for patients with end-stage renal disease (ESRD). Peritoneal dialysis catheters are usually placed using a small laparotomy. This traditional technique is usually safe if well executed, but it cannot be safely performed if the patient has had a previous abdominal operation. A minimally invasive procedure may progress safely by laparoscopic intervention. However, dysfunction of the catheter during a laparoscopic intervention is a common complication related to CAPD. This usually involves intra-abdominal migration of the catheter, even with one intra-abdominal fixation. In an effort to increase catheter survival, we tested a modified laparoscopic technique with two intra-abdominal fixations of a Tenckhoff catheter. MATERIALS AND METHODS Forty-one consecutive ESRD patients (mean age, 53.4 y; range, 31 to 84 y) underwent modified laparoscopic Tenckhoff catheter implantation with 2 intra-abdominal fixations between September 2009 and January 2013. The same perioperative protocol and surgical technique were used in all patients. Another 49 ESRD patients who had received laparoscopic Tenckhoff catheter implantation with 1 intra-abdominal fixation performed by the same surgeon were retrospectively recruited for comparison. RESULTS The modified laparoscopic procedure with two intra-abdominal fixations of a Tenckhoff catheter was successfully performed in all patients. The mean operating time was 24.3 minutes (range, 15 to 37 min). The mean blood loss was 5.6 mL (range, 5 to 20 mL). Catheter survival was 100% until February 2013. No major perioperative complications were found. A Kaplan-Meier Survival Analysis found no significant difference between the 2 groups in sex, age, operative time, or blood loss. The catheter survival rate was significantly higher in the patients with two intra-abdominal fixations. Most patients were satisfied with the functional results of the Tenckhoff catheter. CONCLUSIONS The laparoscopic 2-site fixation technique is an effective and safe procedure but long-term follow-up and more cases are necessary.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Peritoneal dialysis
Catheters, Indwelling
Peritoneal Dialysis, Continuous Ambulatory
Laparotomy
medicine
Humans
Survival rate
Survival analysis
Aged
Retrospective Studies
Aged, 80 and over
business.industry
General surgery
Continuous ambulatory peritoneal dialysis
Equipment Design
Perioperative
Middle Aged
Surgery
Catheter
Kidney Failure, Chronic
Female
Laparoscopy
business
Complication
Subjects
Details
- ISSN :
- 15304515
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
- Accession number :
- edsair.doi.dedup.....56b3d326560353913362a650eea7c086
- Full Text :
- https://doi.org/10.1097/sle.0000000000000043