Comparison of Straight and Curled Tenckhoff Peritoneal Dialysis Catheters Implanted by Percutaneous Technique: A Prospective Randomized Study

Abstract

Objective To examine the impact of peritoneal dialysis catheter configuration, curled or straight catheter, on catheter survival and mechanical and infectious complications. Design Prospective randomized trial. Setting Department of Nephrology of a single university hospital. Patients Seventy-two consecutive patients initiating peritoneal dialysis were randomized to receive either a single cuff straight catheter or a single cuff curled catheter, implanted by percutaneous technique. Results Significantly higher (p < 0.01) survival rate of the curled as compared to the straight catheter. The difference in catheter survival was due to a significantly higher (p < 0.01) incidence of drainage failure associated with catheter tip migration of the straight catheter than of the curled catheter. No difference in infectious complication between the two types of catheters was seen. Catheter survival at 12 months was 77% for the curled catheter and 36% for the straight catheter. Conclusion This study demonstrates superiority of the curled Tenckhoff peritoneal dialysis catheter survival as compared to the straight catheter. This difference in catheter survival is due to the higher displacement rate of the straight catheter.

Long‐Term Complication Rates and Survival of Peritoneal Dialysis Catheters: The Role of Percutaneous Versus Surgical Placement

“…Cuff extrusion was strongly associated with the presence of ESI. Also, in agreement with previous studies (29), the straight catheters compared with coiled ones displayed a fourfold and sevenfold higher risk for outflow failure and migration, respectively. Therefore we consider PDC configuration as the most important factor for tip migration and outflow failure.…”

Percutaneous and Surgical Insertion of Peritoneal Catheter in Patients Starting in Chronic Dialysis Therapy: A Comparative Study

“…These results indicate that a well-planned and implemented technique may avoid the need for direct or The total incidence of peritonitis episodes was one every 29.5 months (0.44 episodes/patient-year) and no significant difference was verified regarding this complication among the groups. These results were very similar to those reported in the literature for percutaneous and surgical catheter placements (22,(26)(27)(28)31,32,34). On the other hand, there are few publications on image-guided procedures, with some reports describing an incidence of one episode of peritonitis every 14.5-21.1 months (33)(34)(35).…”

“…Concerning the incidence of dialysate leakage, there are even more conflicting results in the literature. In percutaneous insertions, not guided by radioscopy, it has been reported that the incidence of this complication can be higher than 20-30% (26)(27)(28)(29). On the other hand, with regard to surgical technique, this specific complication is apparently less common ranging from 0.9 to 15.3% (31,34).…”

“…The most common noninfectious complication in the present study was CD. The incidence of this complication according to some reports varies between 3.2 and 34.7%, in percutaneous insertions, which did not use image guidance (21)(22)(23)(24)(25), whereas in surgical insertions, CD has been verified to take place from 3.2 to 20% of the procedures according to the report (26)(27)(28)(29)(30)(31). On the other hand, a CD rate of 20% (32)(33)(34)(35) has been observed in PD catheters, which were placed by radioscopy guidance.…”

Peritoneal catheter fixation combined with straight upward tunnel and low implant position to prevent catheter malfunction

“…6,7 Although different types of PD catheter such as tenckhoff straight, swan-neck and tenckhoff coiled catheter have been designed and used, there's no consensus on which type of catheter is better. [8][9][10] The ideal type of catheter may depend on the operative insertion technique. 11 Thus, in this study, we developed a new open laparotomy surgery technique with catheter fixation to the lower abdominal wall combined with a straight upward tunnel, a low implant position and a shorter intra-abdominal catheter section.…”