In our experience AOP and LIP approaches have shown the same outcomes. However, we believe that the LIP technique has potential benefits and it should be considered in the decision process of IJV cannulation.
Aim: Catheter dislocation is an important cause of technique failure for peritoneal dialysis (PD). Aim of this study is to evaluate the effect of intramural trait configuration on this outcome. Methods: We considered 240 swan neck, double-cuffed catheters positioned in adult patients in our Centre with mini-laparotomy technique partitioned, according with the intramural segment design, in a standard technique group (ST) (n. 199): oblique passage of the catheter through the rectus sheath in the craniocaudal direction, and in a modified technique group (MT) (n. 41): anterior fascia lanced 3 cm cranially to the deep cuff to let catheter out. The primary end-point was dialysis failure due to tip migration. Secondary end-points were any other causes of catheter removal. Results: Incidence of catheter removal for non-responsive tip migration was 14.3% in MT and 6.1% in ST. Neither this difference nor the catheter survival rate for this outcome was statistically significant. PD interruption for refractory exit site/tunnel infection (ESI) was in favour of ST (4% ST, 35.7% MT; P < .01) whereas ESI catheter survival rate was only marginally significant (292.8 days in MT vs 743.6 in ST, P = .045). No other recorded cause of PD discontinuation was significantly different. Conclusion: Modified technique group is associated with a major ESI risk but, given
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