A Prospective Study to Compare Subcutaneously Buried Peritoneal Dialysis Catheter Technique with Conventional Technique

Wu, Chia-Chun; Su, Pei Fang; Chiang, Shou Shang

doi:10.1159/000101027

Cited by 12 publications

(7 citation statements)

References 17 publications

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“…Data presented in a prospective study looking at subcutaneously buried versus unburied catheter placement technique showed an overall similar risk of peritonitis development [17] . Comparable findings were reported by another prospective study investigating the Moncrief-Popovich design and insertion technique, showing no difference in incidence of peritonitis [18] . Another observational study showed a reduced rate of surgical, mechanical, and infectious complications with the buried placement technique, although the primarily descriptive nature of the study limited its validity as well as reproducibility [19] .…”

Section: Discussionsupporting

confidence: 72%

Outcomes of peritoneal dialysis catheter configurations and pelvic fixation

Pandya

Wagner

Yuo

et al. 2019

Surgery Open Science

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Background Laparoscopic peritoneal dialysis catheter placement has expanded indications, although a relative paucity of data exists about the best configuration for improving outcomes. The purpose of this study is to investigate the role of different catheter configurations and pelvic fixation on catheter and patient outcomes. Methods Retrospective chart review of patients undergoing peritoneal dialysis catheter implantation between January 1, 2013, and December 31, 2016. All procedures were conducted laparoscopically at a single center. Statistical analyses were conducted using Stata/SE 14.2. Results Buried catheter configuration was a statistically significant predictor of peritonitis compared to unburied configuration (P = 0.008). Buried catheter was exteriorized at 100 days (SD 107.8). A longer length of time to exteriorization significantly correlated with peritonitis, need for revision, and need for revision pelvic fixation (P < 0.05). Additionally, initial pelvic fixation was a significant predictor of revision (HR 3.94). Conclusions Peritoneal dialysis catheter placement via a laparoscopic approach can be successfully performed in a diverse patient mix with positive results. However, buried catheter configuration and prophylactic pelvic fixation should be carefully employed in select patients.

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Section: Discussionsupporting

confidence: 72%

Outcomes of peritoneal dialysis catheter configurations and pelvic fixation

Pandya

Wagner

Yuo

et al. 2019

Surgery Open Science

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“…The novel aspect of this technique was the potential reduction in exit-site and peritoneal infections because of the lack of an exit site (which serves as an entry port for bacteria) and the elimination of biofilm. Notwithstanding the initial motives, the MP technique has not consistently been shown to lower the incidence of PD-related infections (3-10). However, the technique does offer several potential advantages: it is more cost-effective, because follow-up clinic visits and catheter flushing are unnecessary; it applies to PD the concept of early access that is analogous to the arteriovenous fistula in hemodialysis (11); and subcutaneous burial of the distal portion of the catheter may be more cosmetically acceptable to patients.…”

mentioning

confidence: 99%

Prolonged Duration of Peritoneal Dialysis Catheter Embedment Does not Lower the Catheter Success Rate

et al. 2011

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Duration of catheter embedment before externalization did not affect catheter survival and did not influence subsequent peritoneal membrane transport status. The overall effect of increasing embedment duration by 30 days is, at most, a 20.6% increase or decrease in the hazard of catheter failure, but the actual hazard may be much smaller or nonexistent. Larger studies are needed to further explore the ideal duration of embedment.

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“…A larger series by Wu et al. 7, 5 comprising 214 participants supports this with the finding that catheter survival and peritonitis rates were similar in those who received buried and non-buried catheters. This study, however, did find that there was a trend towards a reduced healthcare cost associated with buried catheters.…”

Section: Discussionmentioning

confidence: 78%

Outcomes in buried versus non-buried peritoneal dialysis catheters: A retrospective cohort study

et al. 2020

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Aims: To compare the rates of infections (peritonitis and exit site infections) in patients undergoing non-buried versus buried peritoneal dialysis catheterisation for end-stage renal failure. Methods: A retrospective review of all patients who underwent peritoneal dialysis catheter placement by one primary surgeon between January 2008 and August 2019. Information collected included, catheter characteristics, immediate post-operative complications, date of catheter exteriorisation, date of peritoneal dialysis commencement, rate of successful catheter function at initiation of peritoneal dialysis and rates of catheter-related complications (i.e. infection, revision status and obstruction). Results: 110 peritoneal dialysis catheters were inserted (43 non-buried and 67 buried peritoneal dialysis catheters). The non-buried group was associated with a higher proportion acquiring an infection than the buried group (15% vs 30%, p = 0.054). Patients with buried catheters also had a 72% and 65% decreased likelihood of experiencing a catheter-related infection and peritonitis, respectively, over time compared to patients with non-buried catheters in the unadjusted (crude incidence rate ratio 0.28, 95% confidence interval 0.11, 0.70; P = 0.003). The proportion of catheter function at first use was 85% in the non-buried group and 78% in the buried group. Patients with non-buried versus buried catheters had similar proportions of complications, including: obstructions (25.6% vs 20.9%, p = 0.770), herniation (7.0% vs 4.0%, p = 0.327) and leaks (7.0% vs 1.5%, p = 0.134). Conclusion: The use of the buried peritoneal dialysis catheter technique as compared to the standard technique has revealed fewer overall catheter-related infections, particularly episodes of peritonitis and similar rates of mechanical complications in our series. In addition to that, the other benefits of buried peritoneal dialysis catheters such as lower healthcare cost, patient convenience and a viable option for patients in remote communities should prompt physicians to continue assessing suitable candidates for buried peritoneal dialysis catheters.

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A Prospective Study to Compare Subcutaneously Buried Peritoneal Dialysis Catheter Technique with Conventional Technique

Cited by 12 publications

References 17 publications

Outcomes of peritoneal dialysis catheter configurations and pelvic fixation

Outcomes of peritoneal dialysis catheter configurations and pelvic fixation

Prolonged Duration of Peritoneal Dialysis Catheter Embedment Does not Lower the Catheter Success Rate

Outcomes in buried versus non-buried peritoneal dialysis catheters: A retrospective cohort study

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