Document Detail


Laparoscopic placement of peritoneal dialysis catheters: 7 years experience.
MedLine Citation:
PMID:  12608971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Cu T Lu; David I Watson; Tony J Elias; Randall J Faull; Anthony R Clarkson; Kym M Bannister
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  ANZ journal of surgery     Volume:  73     ISSN:  1445-1433     ISO Abbreviation:  ANZ J Surg     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-28     Completed Date:  2003-08-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  109-11     Citation Subset:  IM    
Affiliation:
The University of Adelaide, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
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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