Laparoscopic internal fixation is a viable alternative option for continuous ambulatory peritoneal dialysis catheter insertion / 대한외과학회지
Journal of the Korean Surgical Society
; : 381-387, 2012.
Article
en En
| WPRIM
| ID: wpr-209287
Biblioteca responsable:
WPRO
ABSTRACT
PURPOSE: One of the major drawbacks of peritoneal dialysis (PD) is catheter migration and dysfunction. Preventing catheter migration is one of the main concerns. We compared laparoscopic internal fixation method with open surgical method for catheter migration rates. METHODS: From January 2008 to August 2009, PD catheters were inserted by laparoscopic fixation (LF) method in 22 patients and by open surgery (OS) in 32 patients. Clinical data were reviewed retrospectively. The frequency of migration, peritonitis, and other complications were compared. Catheter and patient survival rates were also compared. RESULTS: The mean age and sex ratio were not different between groups. Mean follow-up duration was 29.1 months in LF group and 26.1 months in OS group. More patients in LF group (27.3%) had history of laparotomy than in OS group (3.1%) (P = 0.01). The mean operation time was significantly longer in LF group (101.6 +/- 30.4 minutes) than in OS group (72.4 +/- 26.03 minutes) (P = 0.00). The cumulative incidence of catheter migration was 65.6% in OS group and 13.6% in LF group (P = 0.00). Migration-free catheter survival was higher in LF group (P = 0.001). There were no differences in complication rates between groups. Overall catheter survival was similar (P = 0.93). Patient survival rate at 2 years was not different (P = 0.13). CONCLUSION: Laparoscopic internal fixation of continuous ambulatory peritoneal dialysis catheter significantly reduces migration rates without any addition of complications. Also, laparoscopic technique did not incur patient morbidity or mortality despite the requirement for general endotracheal anesthesia and longer operation time. Therefore, internal fixation can be afforded safely in patients with previous abdominal surgery as either a salvage or preventive measure in patients with repeated catheter migration.
Palabras clave
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Peritonitis
/
Razón de Masculinidad
/
Incidencia
/
Tasa de Supervivencia
/
Estudios Retrospectivos
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Estudios de Seguimiento
/
Diálisis Peritoneal
/
Diálisis Peritoneal Ambulatoria Continua
/
Laparoscopía
/
Catéteres
Tipo de estudio:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Journal of the Korean Surgical Society
Año:
2012
Tipo del documento:
Article