scholarly journals A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival

2014 ◽  
Vol 85 (4) ◽  
pp. 920-932 ◽  
Author(s):  
Sander M. Hagen ◽  
Jeffrey A. Lafranca ◽  
Jan N.M. Ijzermans ◽  
Frank J.M.F. Dor
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Complication Rate ◽  
Meta Analysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival

Different techniques for peritoneal dialysis catheter implantation: A systematic review and network meta-analysis

2020 ◽  
pp. 089686082095372
Author(s):  
Zhiyun Zang ◽  
Xiao Qiu ◽  
Lichuan Yang ◽  
Xin Wang ◽  
Zi Li
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Observational Studies ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival ◽  
Credible Intervals ◽  
Exit Tunnel

The current consensus recommended the peritoneal dialysis catheter (PDC) techniques based on the patients’ anesthesia situation and previous abdominal surgery. However, the research comparing of all the existing PDC techniques is lacking. The objective was to compare the efficacy and safety of PDC techniques by network meta-analysis (NMA). A systematic review of databases was conducted to identify eligible studies. NMA was used to estimate the ranking for endpoints. Our NMA included 41 studies (9 randomized controlled trials (RCTs) and 32 observational trials) and enrolled 3902 patients, comparing three techniques: the laparoscopic catheterization (LC), open surgery catheterization (OSC), and percutaneous catheterization (PC). NMA in RCTs showed OSC had the highest incidence of catheter mechanical dysfunction, PC and LC were very similar, but this result had no statistical difference. NMA in observational studies showed that LC had the highest 1-year catheter survival but without statistical difference (LC vs. OSC: odds ratio (OR) 1.75, 95% credible intervals (CrIs) 0.90–3.40; PC vs. OSC: OR 1.55, 95% CrIs 0.80–2.97; PC vs. LC: OR 0.88, 95% CrIs 0.54–1.44). OSC had the lowest incidence for bleeding. The complications of leakage, peritonitis, and exit/tunnel infection were inconclusive due to the inconsistent results between RCTs and observational studies. Our NMA revealed LC may have the best 1-year catheter survival. PC and LC might be efficacious in lowering the mechanical dysfunction. OSC had the lowest incidence for bleeding. More RCTs with larger scale and higher quality are needed in order to obtain more credible evidence.

scholarly journals Advanced Laparoscopic Peritoneal Dialysis Catheter Insertion: Systematic Review and Meta-Analysis

2018 ◽  
Vol 38 (3) ◽  
pp. 163-171 ◽  
Author(s):  
Badri M. Shrestha ◽  
Donna Shrestha ◽  
Avneesh Kumar ◽  
Alice Shrestha ◽  
Simon A. Boyes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Peritoneal Dialysis Catheter ◽  
Exit Site ◽  
Catheter Survival ◽  
Catheter Obstruction ◽  
Advanced Laparoscopy

BackgroundThe optimal methodology of establishing access for peritoneal dialysis (PD) remains controversial. Previously published randomized controlled trials and cohort studies do not demonstrate an advantage for 1 technique over another. Four published meta-analyses comparing outcomes of laparoscopic versus open PD catheter (PDC) insertion have given inconsistent conclusions and are flawed since they group basic and advanced laparoscopy together. The aim of this systematic review and meta-analysis is to examine whether advanced laparoscopic interventions consisting of rectus sheath tunneling and adjunctive procedures produce a better outcome than open insertion or basic laparoscopy used only to verify the catheter position.MethodsA literature search using Medline, Embase, and Cochrane Database was performed, and meta-analysis was performed using RevMan 5.3.5 software (Nordic Cochrane Centre, The Cochrane Collaboration, London, UK). Outcomes evaluated incidence of catheter obstruction, migration, pericannular leak, hernia, infectious complications (peritonitis and exit-site infection) and catheter survival.ResultsOf the 467 records identified, 7 cohort studies, including 1,045 patients, were included in the meta-analysis. When advanced laparoscopy was compared with open insertion, a significant reduction was observed in the incidence of catheter obstruction (odds ratio [OR] 0.14, 95% confidence interval [CI] 0.03 – 0.63; p = 0.01), catheter migration (OR 0.12, 95% CI 0.06 – 0.26; p = 0.00001), pericannular leak (OR 0.27, 95% CI 0.11 – 0.64; p = 0.003), and pericannular and incisional hernias (OR 0.29, 95% CI 0.09 – 0.94; p = 0.04), as well as better 1- and 2-year catheter survival (OR 0.52, 95% CI 0.28 – 0.97; p = 0.04 and OR 0.50, 95% CI 0.28 – 0.92; p = 0.03, respectively). Compared with basic laparoscopy, catheter obstruction and migration were significantly lower in the advanced laparoscopic group, whereas catheter survival was similar in both groups. All outcomes, except catheter obstruction, were similar between the basic laparoscopy and open insertion. The infectious complications such as peritonitis and exit-site infections were similar between the 3 groups.ConclusionsAdvanced laparoscopy was associated with a significant superior outcome in comparison with open insertion and basic laparoscopy.

scholarly journals Selective Infracolic Omentecomy and Fixation Reduces Complications after Laparoscopic Assisted Peritoneal Dialysis Catheter Placement

2018 ◽  
Vol I (1) ◽  
pp. 06-11
Author(s):  
Andries Ryckx
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Placement ◽  
P Value ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Exit Site ◽  
Exit Site Infection ◽  
Catheter Survival ◽  
Catheter Obstruction ◽  
Infracolic Omentectomy

Introduction Peritoneal dialysis (PD) as a treatment for patients with end-stage renal disease (ESRD) provides a competitive alternative to hemodialysis (HD). Long-term catheter survival remains challenging and techniques are not standardized. Advanced laparoscopic placement with fixation and omentectomy might increase catheter survival. The goal of our study was to evaluate if selective infracolic omentectomy and fixation reduced complications after CAPD catheter placement. Materials and Methods A prospective database of patients with CAPD catheter placement from March 2004 to March 2015 was analyzed. All procedures were performed laparoscopically assisted and under general anesthesia by a single surgeon. 78 patients were included, there were no exclusion criteria. Statistical analysis was performed with SPSS. Fisher exact test and log-rank test with calculation of P-value was executed. P-value of <0.05 was considered significant. Results Of the 78 patients who underwent catheter placement, 53 (68%) were males and 25 (32%) were females. The mean age was 54 (ranged from 13 to 88 years). Selective infracolic omentectomy was performed in 32 patients if the momentum reached beyond the promontory. Non-resorbable sutures to fix the catheter were applied in 33 patients. The average duration of peritoneal dialysis was 21 months (range from ten days to 84 months). Omentectomy significantly reduced the incidence of catheter obstruction (3 vs. 11%, P=0.028) but not of catheter dislocation (19 vs. 30%, P=0.101). Omentectomy did not significantly increase the incidence of peritonitis (22 vs. 31%,P=0.133) or exit-site infection (16vs 17%, P=0.238). Catheter fixation with non-resorbable sutures reduced catheter dislocation (21 vs. 23%, P=0.226) and catheter obstruction( 12 vs.17%,P=0.223) with a significant reduction of peritonitis (15 vs. 29%, P=0.044) and no effect on exit-site infection (15 vs. 17%,P=0.251). Conclusion Laparoscopic PD catheter placement with selective omentectomy and fixation of the catheter to the abdominal wall is safe and feasible and leads to fewer complications. Key words: peritoneal, dialysis, catheter, complications, laparoscopy, omentectomy.

scholarly journals Preperitoneal Tunneling – a Novel Technique in Peritoneal Dialysis Catheter Insertion

2014 ◽  
Vol 34 (4) ◽  
pp. 443-446 ◽  
Author(s):  
Mohammad-Hadi Saeed Modaghegh ◽  
Gholamhossein Kazemzadeh ◽  
Yaser Rajabnejad ◽  
Fatemeh Nazemian
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Transplantation ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Safe Method ◽  
Catheter Survival ◽  
Catheter Migration ◽  
Novel Technique ◽  
Omental Wrapping

IntroductionThis study describes a new preperitoneal tunneling (PPT) method for inserting a peritoneal dialysis catheter (PDC), thereby lessening surgical complications and increasing the catheter's survival.MethodsThis new technique was used in 23 cases from December 2005 to January 2007 and followed up until March 2011 (63 months). The procedure was performed laparoscopically under local (16 cases) or general (7 cases) anesthesia by one surgeon. Catheter survival is reported by Kaplan-Meyer analysis.ResultsThe catheters were mechanically obstructed in 2/23 cases (8.7%); and were withdrawn due to a peritonitis in 2 cases and inadequacy of peritoneal dialysis in 1 case. Ten patients received kidney transplantation and six died before completing this follow-up period. The patients still reaped the benefits of the PDC until receiving a kidney transplant or death. The 5-year survival rate of the catheter was 89%. No incidence of catheter migration, omental wrapping, herniation or leakage was noticed.ConclusionPreperitoneal tunneling is a simple and safe method for insertion of PDC, and can effectively prevent catheter migration, dislocation and omental wrapping.

scholarly journals Laparoscopic versus Open Peritoneal Dialysis Catheter Insertion: A Meta-Analysis

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e56351 ◽  
Author(s):  
Sander M. Hagen ◽  
Jeffrey A. Lafranca ◽  
Ewout W. Steyerberg ◽  
Jan N. M. IJzermans ◽  
Frank J. M. F. Dor
Keyword(s):  
Peritoneal Dialysis ◽  
Meta Analysis ◽  
Catheter Insertion ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter

scholarly journals Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

2020 ◽  
Author(s):  
Dayang Xie ◽  
Jianhui Zhou ◽  
Xueying Cao ◽  
Qingtao Zhang ◽  
Yanli Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
One Year ◽  
The One

Abstract Background. A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion , although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods. 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results. Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions. Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

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