| Laparoscopic placement of peritoneal dialysis catheters: 7 years experience. | |
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MedLine Citation:
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PMID: 12608971 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Since 1994 we have placed all peritoneal dialysis (Tenckhoff) catheters at our hospital laparoscopically using a technique that incorporates suture fixation into the pelvis. The purpose of this study was to determine the long-term outcome of this approach. METHOD: Perioperative and follow-up data for all patients undergoing placement of a peritoneal dialysis catheter at the Royal Adelaide Hospital were collected prospectively and managed on unit specific and hospital wide computerized databases. A total of 148 procedures were carried out in 123 patients from March 1994 to November 2001. Follow-up ranged from 3 to 68 months (median, 42 months). All procedures were undertaken or supervised by one surgeon, and catheters were routinely sutured into the pelvis at laparoscopy. RESULTS: There was no perioperative mortality in this series, and only one catheter could not be placed laparoscopically. This was in a patient with extensive intra-abdominal adhesions. Mean operative time was 27 min (range, 10-100 min), and mean postoperative stay was 2.8 days (range, 1-12 days). Seven (5%) patients experienced peri/postoperative haemorrhage, and four of these underwent surgical re-exploration. Twenty-five (17%) catheters are still used for dialysis. Thirty-four (23%) catheters were removed when the recipient received a subsequent renal transplant, and 42 (28%) patients died during follow-up. Forty-six (31%) patients required catheter revision or removal because of technical problems; 26 (18%) recurrent peritonitis or exit site infection; and 20 (14%) catheter blockage. Twenty-eight reinsertion procedures were carried out in 25 patients. Ten (7%) patients developed port site hernias at late follow-up, and required hernioplasty. Catheter migration leading to malfunction (poor drainage) occurred in eight (5%) patients only. CONCLUSIONS: Laparoscopic placement of peritoneal dialysis catheters is a safe and effective procedure. The majority of patients will dialyse successfully using this technique. Suturing the catheter tip into the pelvis is associated with a low rate of catheter migration. |
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Authors:
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Cu T Lu; David I Watson; Tony J Elias; Randall J Faull; Anthony R Clarkson; Kym M Bannister |
Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: ANZ journal of surgery Volume: 73 ISSN: 1445-1433 ISO Abbreviation: ANZ J Surg Publication Date: 2003 Mar |
Date Detail:
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Created Date: 2003-02-28 Completed Date: 2003-08-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 101086634 Medline TA: ANZ J Surg Country: Australia |
Other Details:
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Languages: eng Pagination: 109-11 Citation Subset: IM |
Affiliation:
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The University of Adelaide, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Catheters, Indwelling / adverse effects* Female Follow-Up Studies Humans Kidney Failure, Chronic / surgery*, therapy* Laparoscopy / adverse effects* Male Middle Aged Outcome Assessment (Health Care)* Pelvis / surgery Peritoneal Dialysis, Continuous Ambulatory / adverse effects* Postoperative Complications* Suture Techniques / adverse effects* Time Factors Urinary Bladder / surgery Uterus / surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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