scholarly journals A Modified Method in Laparoscopic Peritoneal Catheter Implantation: The Combination of Preperitoneal Tunneling and Pelvic Fixation

ISRN Surgery ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Mehmet Emin Gunes ◽  
Gungor Uzum ◽  
Oguz Koc ◽  
Yiğit Duzkoylu ◽  
Meltem Kucukyilmaz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Survival Rates ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
Pelvic Fixation ◽  
Duration Of Hospital Stay ◽  
Catheter Implantation ◽  
Stage Renal Disease ◽  
End Stage

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is widely accepted for the management of end-stage renal disease (ESRD). Although not as widely used as hemodialysis, CAPD has clear advantages, especially those related to patient satisfaction and simplicity. Peritoneal dialysis (PD) catheter insertion can be accomplished by several different techniques. In this study, we aimed to evaluate our results obtained with peritoneal dialysis catheter placement by combination of pelvic fixation plus preperitoneal tunneling. Material and Methods. Laparoscopic peritoneal catheter implantation by combining preperitoneal tunneling and pelvic fixation methods was performed in 82 consecutive patients with end-stage renal disease. Sex, age, primary disease etiology, complications, mean duration of surgery, mean duration of hospital stay, morbidity, mortality, and catheter survival rates and surgical technique used were assessed. Analysis of catheter survival was performed using the Kaplan-Meier method. Results. Mean follow-up period was 28.35 ± 14.5 months (range of 13–44 months). Mean operative time was 28 ± 6 minutes, and mean duration of hospital stay was 3 ± 1 days. There were no conversions from laparoscopy to other insertion methods. None of the patients developed serious complications during surgery or the postoperative period. No infections of the exit site or subcutaneous tunnel, hemorrhagic complications, abdominal wall hernias, or extrusion of the superficial catheter cuff was detected. No mortality occurred in this series of patients. Catheter survival was found to be 92% at 3 years followup. Conclusions. During one-year followup, we had seven patients of migrated catheters due to separation of pelvic fixation suture from peritoneal surface, but they were reimplanted and fixated again laparoscopically with success. Over a three-year followup period, catheter survival was found to be 92%. In the literature, similar catheter survival rates without combination of the two techniques are reported. As a conclusion, although laparoscopic placement of PD catheters avoids many perioperative and early complications, as well as increasing catheter free survival period and quality of life, our results comparing to other studies in the literature indicate that different laparoscopic placement methods are still in debate, and further studies are necessary to make a more accurate decision.

Peritoneal Catheter Survival and Complications in end Stage Renal Disease

1985 ◽  
Vol 5 (4) ◽  
pp. 229-233 ◽  
Author(s):  
Martin H. Bierman ◽  
Jan Kasperbauer ◽  
Anthony Kusek ◽  
Michael D. Hammeke ◽  
Robert J. Fitzgibbons ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Diabetic Patients ◽  
Life Table Analysis ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
Sex Type ◽  
Table Analysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Catheter Replacement

Peritoneal catheter survival and complications were determined retrospectively over an eight-year period. Two hundred and twenty-two peritoneal catheters were placed in 124 patients; the 107 failures, which required catheter replacement, were due to dislodgment (38), one-way obstruction (31), peritonitis (28), leakage (7), and tunnel infection (3). Forty per cent of all catheter failures occurred within the first week due mainly to dislodgment and obstruction. Females had significantly more leakage-related catheter failures. Diabetic patients had fewer total catheter failures and fewer failures due to peritonitis. Over a 24-month period no difference was seen in the number or types of failures between straight and curled Tenckhoff catheters. By life-table analysis cumulative per cent catheter survival was 45% at 52 weeks; this was not affected by sex, type of catheter, or use of radiography during placement. In patients with multiple peritoneal catheter placements, subsequent catheters did not have a lower survival.

scholarly journals Peritoneal Dialysis Initiation to treat end stage kidney desease during pregnancy. A report of 2 cases.

2021 ◽  
Vol 4 (1) ◽  
pp. 45-52
Author(s):  
Lucas Jacobs ◽  
Saleh Kaysi ◽  
Maria Mesquita ◽  
Christelle Fosso ◽  
Andrew Carlin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Scientific Literature ◽  
Pregnant Patient ◽  
The Other ◽  
Peritoneal Catheter ◽  
History Of ◽  
Prospective Comparative Study ◽  
Stage Renal Disease ◽  
End Stage

Despite strong evidence suggesting that peritoneal dialysis (PD) is a comparable technique to long-hour hemodialysis (HD) for pregnant patients (11,12), few cases are described in the current literature. Moreover, initiating PD in a pregnant woman needing extrarenal epuration is rarely described if at all. In this article, we present two cases of patients who initiated PD while being already multiple month pregnant: the first one 14 years ago and the other today. Our two patients are in their thirties, are respectively 16 and 10 weeks pregnant and have a history of anti-phospholipids syndrome. It was decided to start a PD program with both of them. Our first patient gave birth to a healthy 2.5 kg and 45 cm daughter despite an episode of peritonitis and the freeing of the peritoneal catheter from adherences. Our second patient is currently on dialysis without complications and is now 28 weeks pregnant with a healthy monitored child. Initiating PD in a pregnant patient is a subject that has not yet been published in the current scientific literature. With higher pregnancy rates than ever in the end stage renal disease population (31), we suggest to assess the objective benefits of PD extrarenal epuration method by performing a prospective comparative study between PD and HD.

scholarly journals Comparing the Incidence of Catheter-Related Complications with Straight and Coiled Tenckhoff Catheters in Peritoneal Dialysis Patients—a Single-Center Prospective Randomized Trial

2015 ◽  
Vol 35 (4) ◽  
pp. 443-449 ◽  
Author(s):  
Chu-Jun Ouyang ◽  
Feng-Xian Huang ◽  
Qiong-Qiong Yang ◽  
Zong-Pei Jiang ◽  
Wei Chen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Randomized Trial ◽  
Survival Rates ◽  
Prospective Randomized Trial ◽  
Primary Study ◽  
Catheter Survival ◽  
Catheter Dysfunction ◽  
Catheter Tip ◽  
Stage Renal Disease ◽  
End Stage

♦ObjectivesWe aimed to prospectively compare the incidence of catheter-related complications and catheter survival for straight (SCs) and coiled (CCs) Tenckhoff catheters in peritoneal dialysis (PD) patients.♦MethodsThis open prospective randomized trial recruited 189 PD patients with end-stage renal disease from the department of nephrology, The First Affiliated Hospital of Sun Yat-sen University from 6 November 2007 to 27 August 2008. The patients were randomized to a SC ( n = 99) or a CC ( n = 90) and were then followed for 2 years. All catheter placements were performed by two designated experienced nephrologists who used a standardized institutional placement protocol. The primary study outcomes were catheter-related complications and catheter survival at 1 and 2 years.♦ResultsWe observed no significant differences in clinical and demographic characteristics between the groups at baseline. The overall incidence of catheter dysfunction was higher in the CC group than in the SC group (17.8% vs 7.1%, p = 0.03), and most of the events occurred 4 weeks or more after the catheters were implanted. Catheter tip migration and omental wrapping were the most common causes of catheter dysfunction. Surgical catheter rescue was more common in patients with CCs than in patients with SCs (9 vs 3 patients respectively, p = 0.05). No significant differences were observed in other catheter-related complications, including dialysate leaks, hernias, and PD-related infections (peritonitis, exit-site, and tunnel infections). Catheter survival rates in the SC and CC groups were similar at 1 year (96.7% ± 1.9% vs 96.5% ± 2.0%, p = 0.98) and at 2 years (95.3% ± 2.3% vs 92.4% ± 3.6%, p = 0.76).♦ConclusionsThe incidence of PD catheter–related complications is probably higher with CCs than with SCs. The results of our study suggest that a SC is the better option to reduce subsequent catheter complications.

Synchronous Laparoscopic Insertion of Peritoneal Dialysis Catheter and Cholecystectomy in Patients with End-Stage Renal Disease and Gallstones – Our Experience

2019 ◽  
Vol 39 (5) ◽  
pp. 489-491
Author(s):  
Jurij Janež
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peritoneal Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Gallbladder Polyps ◽  
Stage Renal Disease ◽  
End Stage ◽  
Infective Complications ◽  
Gallbladder Removal

In patients with end-stage renal disease who are candidates for peritoneal dialysis (PD) and have gallstones or gallbladder polyps, it is advised to perform synchronous insertion of PD catheter and cholecystectomy. With gallbladder removal at the time of peritoneal catheter insertion we can avoid infective complications, such as acute cholecystitis and possible PD failure. This article presents our experience with synchronous laparoscopic cholecystectomy and insertion of a PD catheter.

A Technique to Eradicate Tunnel Infection without Peritoneal Dialysis Catheter Removal

1984 ◽  
Vol 4 (3) ◽  
pp. 156-157 ◽  
Author(s):  
Sharon P. Andreoli ◽  
Karen W. West Jay ◽  
L. Grosfeld ◽  
Jerry M. Bergstein
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Major Complication ◽  
Catheter Removal ◽  
Dramatic Improvement ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Stage Renal Disease ◽  
End Stage

In two adolescents maintained on CAPD, infections of the peritoneal catheter tunnel were treated by an “unroofing” technique. The infections were eradicated without catheter removal or interruption of CAPD. Continuous ambulatory peritoneal dialysis (CAPD) has produced a dramatic improvement in the care of patients with end-stage renal disease. Peritonitis remains a major complication and the most common cause of CAPD failure (1–3). Most episodes of peritonitis can be attributed to a break in the technique of bag exchanges; however, tunnel infections are also implicated (3,4). Tunnel infections are difficult to cure and, if persistent, may make necessary the removal of an otherwise well functioning catheter. We describe two patients with tunnel infections that were eradicated after “unroofing” of the Tenckhoff catheter.

18 Months Experience with a New (valli) Catheter for Peritoneal Dialysis

1983 ◽  
Vol 3 (1) ◽  
pp. 22-24 ◽  
Author(s):  
Alberto Valli ◽  
Ugo Crescimanno ◽  
Osario Midiri ◽  
Khaled Arw ◽  
Peter Riegler ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peritoneal Catheter ◽  
Tenckhoff Catheter ◽  
Outflow Rate ◽  
Catheter Failure ◽  
New Type ◽  
Stage Renal Disease ◽  
End Stage

The authors describe their experiences with a new type of peritoneal catheter in 45 patients with end-stage renal disease treated with intermittent (IPD) or continuous ambulatory peritoneal dialysis (CAPD) over 18 months. This new catheter consists of an abdominal part, similar in diameter to the Tenckhoff catheter but with larger holes; this part is enveloped in a silastic balloon with many holes. An important advantage of the new catheter is an outflow rate that is much higher than the Tenckhoff catheter. The incidence of malfunction was considerably reduced an d in addition, there were no cases of catheter failure due to blood or fibrin clots or wrapping by omentum.

scholarly journals Unplanned Start on Peritoneal Dialysis Right after Pd Catheter Implantation for Older People with End-Stage Renal Disease

2015 ◽  
Vol 35 (6) ◽  
pp. 622-624 ◽  
Author(s):  
Johan V. Povlsen ◽  
Anette Bagger Sørensen ◽  
Per Ivarsen
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Older People ◽  
End Stage Renal Disease ◽  
Central Venous ◽  
Increased Risk ◽  
Catheter Implantation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Unplanned Start

Unplanned start on dialysis remains a major problem for the dialysis community worldwide. Late-referred patients with end-stage renal disease (ESRD) and urgent need for dialysis are overrepresented among older people. These patients are particularly likely to be started on in-center hemodialysis (HD), with a temporary vascular access known to be associated with excess mortality and increased risks of potentially lethal complications such as bacteremia and central venous thrombosis or stenosis. The present paper describes in detail our program for unplanned start on automated peritoneal dialysis (APD) right after PD catheter implantation and summarizes our experiences with the program so far. Compared with planned start on PD after at least 2 weeks of break-in between PD catheter implantation and initiation of dialysis, unplanned start may be associated with a slight increased risk of mechanical complications but apparently no detrimental effect on mortality, peritonitis-free survival, or PD technique survival. In our opinion and experience, the risk of serious complications associated with the implantation and immediate use of a PD catheter is less than the risk of complications associated with unplanned start on HD with a temporary central venous catheter (CVC). Unplanned start on APD is a gentle, safe, and feasible alternative to unplanned start on HD with a temporary CVC that is also valid for the late-referred older patient with ESRD and urgent need for dialysis.

scholarly journals Simultaneous bilateral laparoscopic nephrectomy in a child with peritoneal catheter dialysis using a 4-port trans-abdominal technique

2015 ◽  
Vol 9 (1-2) ◽  
pp. 59 ◽  
Author(s):  
Claudio De Carli ◽  
Luis A Guerra
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Laparoscopic Nephrectomy ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Access Port ◽  
Stage Renal Disease ◽  
End Stage ◽  
Fluid Leak

We present the case of an 11-year-old girl with end-stage renal disease and a previously-inserted peritoneal dialysis catheter who underwent a bilateral transperitoneal laparoscopic nephrectomy for hypertension refractory to medical treatment. We employed a 4-port transperitoneal technique using the first detached kidney to occlude the ipsilateral abdominal wall access port during the contralateral nephrectomy to avoid gas/fluid leak and to facilitate location of the first kidney at the end of the surgery. The patient had no morbidity and was able to resume use of the peritoneal dialysis catheter 5 days after the surgery.

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