Laparoscopic Placement of the Tenckhoff Catheter for Peritoneal Dialysis

Tsimoyiannis, Evangelos C.; Siakas, Philipos; Glantzounis, George; Toli, Chrysoula; Sferopoulos, George; Pappas, M.; Manataki, Adamandia

doi:10.1097/00129689-200008000-00007

Cited by 102 publications

(129 citation statements)

References 14 publications

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“…The first were studies of surgical approaches for the insertion of the PD catheter. There were eight trials in total (601 patients), of which three (248 patients) compared insertion of the catheter with laparoscopy versus laparotomy, three (233 patients) compared the effect of subcutaneous burying and resting of the catheter for 6 wk versus standard insertion (resting but no subcutaneous burying of catheter), and two (120 patients) compared midline versus lateral insertion (17)(18)(19)(20)(21)(22)(23)(24). The second group of studies compared the use of straight versus coiled catheters.…”

Section: Trial Characteristicsmentioning

confidence: 99%

Catheter-Related Interventions to Prevent Peritonitis in Peritoneal Dialysis

Strippoli¹,

Tong²,

Johnson³

et al. 2004

Journal of the American Society of Nephrology

162

109

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Abstract. As many as 15 to 50% of end-stage kidney disease patients are on peritoneal dialysis (PD), but peritonitis limits its more widespread use. Several PD catheter-related interventions (catheter designs, surgical insertion approaches, and connection methods) have been purported to reduce the risk of peritonitis in PD. The goal was to assess the trial evidence supporting their use. The Cochrane CENTRAL Registry, MEDLINE, EMBASE, and reference lists were searched for randomized trials of catheter types and related interventions in PD. Two reviewers extracted data on the rates of peritonitis and exit-site/tunnel infection, catheter removal/replacement, technique failure, and all-cause mortality. Analysis was by a random effects model, and results are expressed as relative risk and 95% confidence intervals. Thirty-seven eligible trials (2822 patients) were identified: eight of surgical strategies of catheter insertion, eight of straight versus coiled catheters, 10 of Y-set versus conventional spike systems, four of Y-set versus double-bag systems, and seven of other interventions. Despite the large total number of patients, few trials covered the same interventions, small numbers of patients were enrolled in each trial, and the methodologic quality was suboptimal. Y-set and twin-bag systems were superior to conventional spike systems (seven trials, 485 patients; relative risk, 0.64; 95% confidence intervals 0.53 to 0.77), and no other catheter-related intervention was demonstrated to prevent peritonitis in PD. This systematic review demonstrates that of all catheter-related interventions designed to prevent peritonitis in PD, only disconnect (twin-bag and Y-set) systems have been proved to be effective (compared with conventional spike systems). Despite the importance of PD as a renal replacement therapy modality and the large number of patients who receive it, it is still not known whether any particular PD catheter designs, implantation techniques, or modalities are effective, given the limitations of available trials.

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Section: Trial Characteristicsmentioning

confidence: 99%

Catheter-Related Interventions to Prevent Peritonitis in Peritoneal Dialysis

Strippoli¹,

Tong²,

Johnson³

et al. 2004

Journal of the American Society of Nephrology

162

109

View full text Add to dashboard Cite

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“…When migration occurs, dialysate can be infused but drainage of the fluid from the peritoneal cavity is difficult. Suture fixation of the catheter tip through open laparotomy or laparoscopic method has been introduced to prevent catheter migration [26,27]. The drawback of the open laparotomy technique is the large lower abdominal incision, which is associated with significant morbidity, including adhesion, incisional hernia and intestinal obstruction.…”

Section: Discussionmentioning

confidence: 99%

A Novel three Cuff Peritoneal Dialysis Catheter with Low Entry Technique: Three Years Single Center Experience

Al-Hwiesh¹,

Abdul-Rahman²,

Audah³

et al. 2017

UNOAJ

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Objective: To share our 3-year experience with the new, three-cuff peritoneal dialysis (PD) catheter with the low-entry technique and to study its effect on infectious and non-infectious complications as well as its impact on catheter survival.Methods: This is an observational study which was carried out in a university hospital over 3 years. The study involved 153, three-cuff PD catheter insertions in 150 incident PD patients. The study was carried out in our PD center and extended from December, 2012 till January 2016 with a mean follow-up period of 15 months. All patients used automated peritoneal dialysis (APD). Throughout the study, we analyzed survival rate, functionality and complication profile of our new catheter.Results: Four patients had inguinal hernia and 1 had omental wrapping. Catheter migration, however, was 0.0% with our 3-cuff PD catheter using our new technique. A total of 25 catheters had to be removed. Indications for catheter removal were successful transplantation (n =7), hernia (n =4), omental capture (n =1), ultrafiltration failure (n= 2), Psychological causes (n= 4), abdominal surgery (n= 1), severe tunnel infection (n =3), and unresolved peritonitis (n =3). The rate of peritonitis was as low as 0.106 per patient-year equivalent to 1 episode of peritonitis per 112 patient-months. At the end of the study, catheter survival was 91.3%. Conclusion:The low entry-site of our PD catheter seems to prevent catheter migration. The 3-cuffs probably act as an additional safeguard against peritonitis.

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“…Tradicionalmente, la técnica más usada consiste en la inserción a ciegas del catéter a través de una pequeña laparotomía abdominal baja 6 , con o sin control fluoroscópico. Existen múltiples estudios prospectivos que muestran ventajas de la técnica laparoscópica en relación a menor tasa de infecciones, fugas, disfunción del catéter, mayor acceso funcional inmediato y una menor tasa de revisión y reemplazo del catéter, además de mayor costo-efectividad en comparación con la técnica tradicional [6][7][8][9] . Sin embargo, hasta donde los autores conocemos, no existiría evidencia suficiente para recomendar una técnica por sobre otra.…”

Section: Introductionunclassified

Inserción laparoscópica de catéter de diálisis peritoneal: experiencia de 3 años

et al. 2013

Rev Chil Cir

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Laparoscopic placement of peritoneal dialysis catheters. Experience in 81 patientsBackground: Laparoscopic placement of peritoneal dialysis catheters is associated with a lower rate of complications. Aim: To report the experience in laparoscopic placement of peritoneal dialysis catheters. Material and Methods: Review of medical records of 81 patients aged 15 to 90 years (42 males) subjected to the procedure between 2010 and 2013. Results: A three port plus omentopexy technique was used. Surgical time was 51 minutes. Other simultaneous surgical procedures were performed in four patients. No patient died, had a bowel perforation or required conversion to open surgery. Ninety eight percent of patients were discharged less than 24 hours after the procedure, using standard analgesics. Four patients required a new surgical procedure due to minor complications. All installed catheters were functional until the moment of his review. Conclusions: Laparoscopic placement of peritoneal dialysis catheters is a safe and effective procedure.

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Laparoscopic Placement of the Tenckhoff Catheter for Peritoneal Dialysis

Cited by 102 publications

References 14 publications

Catheter-Related Interventions to Prevent Peritonitis in Peritoneal Dialysis

Catheter-Related Interventions to Prevent Peritonitis in Peritoneal Dialysis

A Novel three Cuff Peritoneal Dialysis Catheter with Low Entry Technique: Three Years Single Center Experience

Inserción laparoscópica de catéter de diálisis peritoneal: experiencia de 3 años

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