scholarly journals SUBCUTANEOUS EMBEDMENT OF THE PERITONEAL DIALYSIS CATHETER BEFORE US (The Moncrief-Popovich Technique) : IS IT STILL USEFULL 25 YEARS LATER ?

2018 ◽  
Vol 1 (2) ◽  
pp. 75-81
Author(s):  
Bertrand Morel
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Infectious Complications ◽  
Bacterial Biofilm ◽  
Proximal Segment ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Healing Phase

Abstract : In 1993 , Moncrief and Popovich described an innovative way of implanting a modified peritoneal catheter , by burying subcutaneously the proximal segment , after a classic laparotomy procedure . They thought that, covering the catheter during  the healing phase, would prevent the constitution of an intra-luminal bacterial biofilm, and, therefore, prevent secondary infectious complications, when performing dialysis. If it did not meet the infectious advantage , it appears that this technique of early implantation of the catheter , allows the onset of the treatment with a watertight and painless abdominal wall , with immediately using maximum volumes of dialysate .  We describe the technique as it was adapted to our center and practiced for more than  twenty years , reporting the results of a study in Chambery between 2006 and 2010 . Finally , we discuss the results published in the  literature .

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.

scholarly journals Minimally invasive peritoneal dialysis catheter insertions with concomitant cholecystectomy or hernioplasty: Surgical technique and our experiences

2021 ◽  
pp. 112972982110394
Author(s):  
Jurij Janež ◽  
Armand Dominik Škapin
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Perioperative Complications ◽  
Demographic Data ◽  
Gallbladder Disease ◽  
Dialysis Access ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Port Site Hernia ◽  
Concomitant Cholecystectomy

Introduction: Peritoneal dialysis is a well-accepted replacement therapy in patients with end-stage renal disease. There are many different options adopted on how to insert a peritoneal dialysis catheter. In our institution, a laparoscopic insertion has become the method of choice for providing peritoneal dialysis access in adult patients. The aim of this study was to analyze surgical outcomes of patients after laparoscopically assisted placement of a PD catheter some of them after concomitant cholecystectomy or hernioplasty. Methods: We have evaluated 70 consecutive patients from 1st of October 2015 to 30th of April 2020 who underwent laparoscopic insertion of a peritoneal dialysis catheter. Demographic data, details about surgery and about peri- and postoperative complications were gathered. Results: Out of 70 enrolled patients, 15 had gallstones (21%) and underwent concomitant laparoscopic cholecystectomy. Three patients (4%) had abdominal wall hernia and underwent concomitant hernioplasty. We observed no perioperative complications connected with any of the performed procedures. There was one early postoperative complication: an early leak of dialysate fluid. Late complications were observed in nine patients (13%): mechanical catheter problems (two patients), peritonitis (three patients), skin exit-site infections (two patients), peri-catheter leak (one patient), and port-site hernia (one patient). Conclusions: For all patients with concomitant gallbladder disease or abdominal wall hernias we suggest to perform synchronous surgeries, due to finding no more complications after concomitant procedures in comparison to patients in whom only a PD catheter was inserted. Concomitant procedures are done to spare patients two separate procedures and to avoid possible complications. We also suggest using the cholecystectomy first, PD catheter insertion second approach for having excellent peri- and postoperative results.

scholarly journals Cutaneous abscess related to peritoneal catheter tunnel infection

2021 ◽  
Author(s):  
Yoshihiro Nakamura ◽  
Tsuyoshi Watanabe ◽  
Naoho Takizawa ◽  
Yoshiro Fujita
Keyword(s):  
Peritoneal Dialysis ◽  
Physical Examination ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Tunnel Infection ◽  
Catheter Infections

Some peritoneal dialysis catheter infections cannot be detected via a physical examination. Ultrasonography can aid in the diagnosis of such infections.

scholarly journals The importance of the peritoneal dialysis catheter material in orderto perform optimum dialysis in veterinary medicine

2020 ◽  
Vol 71 (06) ◽  
pp. 596-599
Author(s):  
BOGDAN ALEXANDRU VIŢĂLARU ◽  
RAZVAN SCARLAT
Keyword(s):  
Veterinary Medicine ◽  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
The Third ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution

This study was conducted on 44 dogs, aged between 10 months and 15 years, weighing between 0.9 and 8.5 kilograms,during 72 months. We created four batches of 11 dogs each. First batch received silicone peritoneal catheters with twoDacron cuffs, second batch received silicone peritoneal catheters without Dacron cuffs, third batch receivedpolypropylene peritoneal catheters with two Dacron cuffs and fourth batch received polypropylene peritoneal catheterswithout Dacron cuffs. All the dogs were treated with the same peritoneal dialysis solution, at the same interval, in thesame doses and at the same temperature and all the peritoneal catheters were straight Blake. In dogs from the firstbatch, we experienced minimum subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at least 90 days. In the second batch, we experienced constant and reduced subcutaneous leaks of peritonealdialysis solution and the catheters were permeable for at least 90 days. In the third batch, we experienced mediumsubcutaneous leaks of peritoneal dialysis solution and the catheters were permeable for at least 45 days. In the fourthbatch, we experienced important subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at most 15 days. The study conclusion is that the best peritoneal catheter it is represented by the silicone peritonealcatheters with two Dacron cuffs.

scholarly journals The importance of the peritoneal dialysis catheter material in orderto perform optimum dialysis in veterinary medicine

2020 ◽  
Vol 71 (06) ◽  
pp. 596-599
Author(s):  
BOGDAN ALEXANDRU VIŢĂLARU ◽  
RAZVAN SCARLAT
Keyword(s):  
Veterinary Medicine ◽  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
The Third ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution

This study was conducted on 44 dogs, aged between 10 months and 15 years, weighing between 0.9 and 8.5 kilograms,during 72 months. We created four batches of 11 dogs each. First batch received silicone peritoneal catheters with twoDacron cuffs, second batch received silicone peritoneal catheters without Dacron cuffs, third batch receivedpolypropylene peritoneal catheters with two Dacron cuffs and fourth batch received polypropylene peritoneal catheterswithout Dacron cuffs. All the dogs were treated with the same peritoneal dialysis solution, at the same interval, in thesame doses and at the same temperature and all the peritoneal catheters were straight Blake. In dogs from the firstbatch, we experienced minimum subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at least 90 days. In the second batch, we experienced constant and reduced subcutaneous leaks of peritonealdialysis solution and the catheters were permeable for at least 90 days. In the third batch, we experienced mediumsubcutaneous leaks of peritoneal dialysis solution and the catheters were permeable for at least 45 days. In the fourthbatch, we experienced important subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at most 15 days. The study conclusion is that the best peritoneal catheter it is represented by the silicone peritonealcatheters with two Dacron cuffs.

scholarly journals Percutaneous insertion of peritoneal dialysis catheters by the nephrologist (modified Seldinger technique)

2021 ◽  
Vol 4 (4) ◽  
pp. 277-288
Author(s):  
Karlien Francois ◽  
Dieter De Clerck ◽  
Tom Robberechts ◽  
Freya Van Hulle ◽  
Stefan Van Cauwelaert ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
Catheter Insertion ◽  
Seldinger Technique ◽  
Prior History ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival ◽  
Set Up ◽  
Percutaneous Insertion

A proper functioning access to the peritoneal cavity is the first and foremost requirement to start peritoneal dialysis. Most commonly, peritoneal dialysis catheters are inserted using a surgical approach. Laparoscopic peritoneal dialysis catheter insertion is the recommended surgical technique because it offers to employ advanced adjunctive procedures that minimize the risk of mechanical complications. In patients with low risk of mechanical catheter complications, such as patients without prior history of abdominal surgery or peritonitis, and in patients ineligible for general anesthesia, the percutaneous approach of peritoneal dialysis catheter insertion is an alternative to surgical catheter insertion. Percutaneous insertion of peritoneal dialysis catheters can be performed by a dedicated nephrologist, interventional radiologist, surgeon or nurse practitioner under local anesthesia, either with or without image guidance using ultrasound or fluoroscopy. Several reports show similar catheter function rates, mechanical and infectious complications and catheter survival for percutaneously inserted peritoneal dialysis catheters compared to surgically inserted peritoneal dialysis catheters. This article describes the percutaneous insertion of peritoneal dialysis catheters technique adopted at Universitair Ziekenhuis Brussel since 2015. Our technique is a simple low-tech modified Seldinger procedure performed by the nephrologist and not using fluoroscopy guidance. We describe the excellent outcomes of our percutaneously inserted peritoneal dialysis catheters and offer a practical guide to set up your own percutaneous catheter insertion program.

scholarly journals A New Simplified One-Port Laparoscopic Technique for Peritoneal Dialysis Catheter Placement

2014 ◽  
Vol 34 (1) ◽  
pp. 109-113 ◽  
Author(s):  
Chun-Yu Kao ◽  
Jiin-Haur Chuang ◽  
Shin-Yi Lee
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Catheter Placement ◽  
Laparoscopic Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Migration ◽  
Tenckhoff Catheter ◽  
Good Cosmesis

BackgroundVarious techniques for laparoscopic insertion of a peritoneal dialysis catheter have been described. Usually 2 – 3 ports are required, and complications related to the port sites (such as abdominal wall hernia, leakage, and hemorrhage) cannot be avoided. To minimize the potential complications, we designed a simplified 1-port laparoscopic technique for peritoneal dialysis catheter placement.MethodsWe conducted a retrospective data review of 44 patients who underwent 1-port laparoscopic insertion of a Tenckhoff catheter from June 2009 to February 2011. All patient data, including postoperative complications, were analyzed.ResultsThe mean follow-up period was 11.52 months. All catheters were working properly, except in 1 patient who developed peritonitis 3 months after catheter placement. (The catheter was removed.) No postoperative abdominal wall hemorrhage, early leaks, hernias, or catheter migration occurred. No exit-site or tunnel infections were observed.ConclusionsOur 1-port laparoscopic technique provides excellent catheter fixation, avoids excessive port sites, and yields good cosmesis. The low complication rate and the simplicity of the method justify its standard use for Tenckhoff catheter placement.

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.

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

2019 ◽  
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.

Peritoneal Dialysis Catheter Position Evaluated by Ultrasound: Can it Replace Abdomen X-Ray in Patients Presenting Catheter Misplacement?

2017 ◽  
Vol 38 (05) ◽  
pp. 538-543
Author(s):  
Matthias Zeiler ◽  
Luca Zanoli ◽  
Rosalia Scarfia ◽  
Stefano Santarelli ◽  
Antonio Granata
Keyword(s):  
Peritoneal Dialysis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Kappa Coefficient ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Position ◽  
X Ray ◽  
Catheter Malfunction

Abstract Background Malfunction of the peritoneal dialysis catheter is frequently caused by dislocation. The diagnostic approach is classically based on abdomen X-ray together with detailed case history and physical examination. Despite being rarely applied in clinical practice to evaluate catheter misplacement, ultrasound is a noninvasive, radiation-free technique that is potentially useful also to explore reasons for catheter malfunction. Consequently, we aimed to evaluate the diagnostic accuracy of ultrasound to identify peritoneal catheter misplacement. Methods In a multicenter observational blinded study, we compared ultrasound to abdomen X-ray for catheter localization in 93 consecutive peritoneal dialysis patients with dialysate outflow problems enrolled in two nephrology and dialysis units. The position of the catheter was annotated on a standard scheme of nine abdominopelvic regions. The sensitivity, specificity, positive and negative predictive value and Kappa coefficient were calculated. Results Dislocation out of the inferior abdominopelvic regions was present in 19 patients (20 %) at X-ray and 23 patients (25 %) at ultrasound. Correct determination of the position of the catheter in the lower abdomen by ultrasound had a sensitivity of 93 % (95 % CI 84 – 97 %), specificity of 95 % (95 % CI 72 – 100 %), positive predictive value of 99 % (95 % CI 91 – 100 %), negative predictive value of 78 % (95 %CI 56 – 92 %) and Kappa coefficient of 0.82 (95 % CI 0.67 – 0.96). In 10 out of 93 patients (11 %), there was a position mismatch between X-ray and ultrasound in an adjacent abdominopelvic region. Conclusion Our results suggest that abdomen X-ray for the evaluation of peritoneal catheter position can be replaced by ultrasound in experienced hands. This bedside diagnostic procedure might reduce costs, the time necessary for diagnosis and lifetime radiation exposure.

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