A COMPARATIVE ANALYSIS OF PERCUTANEOUS AND OPEN SURGICAL TECHNIQUESFOR PERITONEAL CATHETER PLACEMENT.

Hdl Handle:
http://hdl.handle.net/10147/237976
Title:
A COMPARATIVE ANALYSIS OF PERCUTANEOUS AND OPEN SURGICAL TECHNIQUESFOR PERITONEAL CATHETER PLACEMENT.
Authors:
Medani, Samar; Shantier, Mohamed; Hussein, Wael; Wall, Catherine; Mellotte, George
Affiliation:
Nephrology, Adelaide &
Citation:
A COMPARATIVE ANALYSIS OF PERCUTANEOUS AND OPEN SURGICAL TECHNIQUESFOR PERITONEAL CATHETER PLACEMENT. 2012: Perit Dial Int
Journal:
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
Issue Date:
1-May-2012
URI:
http://hdl.handle.net/10147/237976
DOI:
10.3747/pdi.2011.00187
PubMed ID:
22550118
Abstract:
BACKGROUND: Peritoneal dialysis (PD) is the preferred available option of renal replacement therapy for a significant number of end-stage kidney disease patients. A major limiting factor to the successful continuation of PD is the long-term viability of the PD catheter (PDC). Bedside percutaneous placement of the PDC is not commonly practiced despite published data encouraging use of this technique. Its advantages include faster recovery and avoidance of general anesthesia.♢ METHODS: We carried out a retrospective analysis of the outcomes of 313 PDC insertions at our center, comparing all percutaneous PDC insertions between July 1998 and April 2010 (group P, n = 151) with all surgical PDC insertions between January 2003 and April 2010 (group S, n = 162).♢ RESULTS: Compared with group P patients, significantly more group S patients had undergone previous abdominal surgery or PDC insertion (41.8% vs 9.3% and 33.3% vs 3.3% respectively, p = 0.00). More exit-site leaks occurred in group P than in group S (20.5% vs 6.8%, p = 0.002). The overall incidence of peritonitis was higher in group S than in group P (1 episode in 19 catheter-months vs 1 episode in 26 catheter-months, p = 0.017), but the groups showed no significant difference in the peritonitis rate within 1 month of catheter insertion (5% in group P vs 7.4% in group S, p =0.4) or in poor initial drainage or secondary drainage failure (9.9% vs 11.7%, p = 0.1, and 7.9% vs 12.3%, p = 0.38, for groups P and S respectively). Technical survival at 3 months was significantly better for group P than for group S (86.6% vs 77%, p = 0.037); at 12 months, it was 77.7% and 68.7% respectively (p = 0.126). No life-threatening complications attributable to the insertion of the PDC occurred in either group.♢ CONCLUSIONS: Our analysis demonstrates further encouraging outcomes of percutaneous PDC placement compared with open surgical placement. However, the members of the percutaneous insertion group were primarily a selected subset of patients without prior abdominal surgery or PDC insertion, therefore limiting the comparability of the groups. Studies addressing such confounding factors are required. Local expertise in catheter placement techniques may affect the generalizability of results.
Item Type:
Article
Language:
en
ISSN:
1718-4304

Full metadata record

DC FieldValue Language
dc.contributor.authorMedani, Samaren_GB
dc.contributor.authorShantier, Mohameden_GB
dc.contributor.authorHussein, Waelen_GB
dc.contributor.authorWall, Catherineen_GB
dc.contributor.authorMellotte, Georgeen_GB
dc.date.accessioned2012-08-09T13:40:34Z-
dc.date.available2012-08-09T13:40:34Z-
dc.date.issued2012-05-01-
dc.identifier.citationA COMPARATIVE ANALYSIS OF PERCUTANEOUS AND OPEN SURGICAL TECHNIQUESFOR PERITONEAL CATHETER PLACEMENT. 2012: Perit Dial Inten_GB
dc.identifier.issn1718-4304-
dc.identifier.pmid22550118-
dc.identifier.doi10.3747/pdi.2011.00187-
dc.identifier.urihttp://hdl.handle.net/10147/237976-
dc.description.abstractBACKGROUND: Peritoneal dialysis (PD) is the preferred available option of renal replacement therapy for a significant number of end-stage kidney disease patients. A major limiting factor to the successful continuation of PD is the long-term viability of the PD catheter (PDC). Bedside percutaneous placement of the PDC is not commonly practiced despite published data encouraging use of this technique. Its advantages include faster recovery and avoidance of general anesthesia.♢ METHODS: We carried out a retrospective analysis of the outcomes of 313 PDC insertions at our center, comparing all percutaneous PDC insertions between July 1998 and April 2010 (group P, n = 151) with all surgical PDC insertions between January 2003 and April 2010 (group S, n = 162).♢ RESULTS: Compared with group P patients, significantly more group S patients had undergone previous abdominal surgery or PDC insertion (41.8% vs 9.3% and 33.3% vs 3.3% respectively, p = 0.00). More exit-site leaks occurred in group P than in group S (20.5% vs 6.8%, p = 0.002). The overall incidence of peritonitis was higher in group S than in group P (1 episode in 19 catheter-months vs 1 episode in 26 catheter-months, p = 0.017), but the groups showed no significant difference in the peritonitis rate within 1 month of catheter insertion (5% in group P vs 7.4% in group S, p =0.4) or in poor initial drainage or secondary drainage failure (9.9% vs 11.7%, p = 0.1, and 7.9% vs 12.3%, p = 0.38, for groups P and S respectively). Technical survival at 3 months was significantly better for group P than for group S (86.6% vs 77%, p = 0.037); at 12 months, it was 77.7% and 68.7% respectively (p = 0.126). No life-threatening complications attributable to the insertion of the PDC occurred in either group.♢ CONCLUSIONS: Our analysis demonstrates further encouraging outcomes of percutaneous PDC placement compared with open surgical placement. However, the members of the percutaneous insertion group were primarily a selected subset of patients without prior abdominal surgery or PDC insertion, therefore limiting the comparability of the groups. Studies addressing such confounding factors are required. Local expertise in catheter placement techniques may affect the generalizability of results.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysisen_GB
dc.titleA COMPARATIVE ANALYSIS OF PERCUTANEOUS AND OPEN SURGICAL TECHNIQUESFOR PERITONEAL CATHETER PLACEMENT.en_GB
dc.typeArticleen
dc.contributor.departmentNephrology, Adelaide &en_GB
dc.identifier.journalPeritoneal dialysis international : journal of the International Society for Peritoneal Dialysisen_GB
dc.description.provinceLeinsteren

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