Minilaparotomy Salvage of Malfunctioning Catheters in Peritoneal Dialysis

Li, Jian-Ri; Cheng, Chi-Hung; Chiu, Kun‐Yuan; Cheng, Chen-Li; Yang, Chi‐Rei; Ho, Hao-Chung; Ko, Jiunn‐Liang; Ou, Yen‐Chuan

doi:10.3747/pdi.2011.00237

Cited by 14 publications

(8 citation statements)

References 12 publications

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“…As mentioned in the introduction, minilaparotomy has been reported by surgeons, with a minimum of 28 min and a maximum of 51 min [6,7]. In contrast, nephrologists had significantly longer operative times, with additional operations such as omental resection taking more than 2 h. However, there was no complication due to anesthesia, and resumption of PD without leakage was possible.…”

Section: Discussionmentioning

confidence: 99%

“…In 2008, Kim et al reported minilaparotomy under local anesthesia for catheter malfunction by surgeons for the first time [6]. Li et al, a Taiwanese urologists, also performed a small laparotomy for catheter malfunction and performed simultaneous catheter abdominal wall fixation, demonstrating its usefulness [7]. A number of nephrologists in Japan have reportedly been performing surgeries related to peritoneal access [8].…”

Section: Introductionmentioning

confidence: 99%

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Minilaparotomy for malfunctioning peritoneal dialysis catheter by nephrologists: experiences at two centers

et al. 2020

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Catheter malfunction is one of the most important complications of peritoneal dialysis (PD). We have performed minilaparotomy for catheter repair by nephrologists. This study aimed to evaluate the effectiveness and safety of the surgery. The surgery was performed 11 times on 10 PD patients with catheter malfunction (3 man, 7 women; mean age 54.3 ± 14.6 years; 4 diabetes, 3 glomerulonephritis, 3 other) at two hospitals. All patients had inflow and/ or outflow obstruction. One patient had inserted the PD catheter using conventional surgical technique, and the remaining nine patients had used Moncrief-Popovich technique. Seven patients with catheters embedded using the Moncrief-Popovich technique showed catheter occlusion at the time of externalization. The remaining three patients experienced catheter obstruction 6.0 ± 2.9 months after commencing PD. The cause of obstruction was fibrin in six patients, wrapping by fimbriae of the fallopian tube in two patients, omentum wrapping in two patients. One patient had no blockage in the catheter. Operative time was 97 ± 46 min, and no intraoperative complications were observed. PD was interrupted for 5.9 ± 3.0 days and was resumed without leakage in all patients. However, catheter malfunction recurred in one patient 3 months after the surgery. The mean hospital stay was 22.4 ± 14.7 days. Minilaparotomy by nephrologists is a safety and suitable for the management of catheter malfunction. In addition, it is necessary to always consider the possibility that the catheter has been occluded at the time of externalization in the Moncrief-Popovich technique.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minilaparotomy for malfunctioning peritoneal dialysis catheter by nephrologists: experiences at two centers

et al. 2020

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“…Laparotomy and laparoscopic correction with or without omentectomy and catheter fixation are another technique for revision of the catheter malposition [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Catheter Fixation Behind the Urachus: A Novel Laparoscopic Technique to Revise Malfunctioning Peritoneal Dialysis Catheters

Kachoei¹,

Rafiei²,

Noori³

et al. 2018

Surgery Curr Res

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Peritoneal dialysis is one of the types of renal replacement therapy which is commonly used in patients with the end-stage renal disease. The cost-effectiveness and easy usage are the advantages of peritoneal dialysis. However, peritoneal dialysis is not always free of a problem and among all of its complications, catheter tip migration and omental wrapping are more common as are considered as the causes of catheter malfunctioning. Different techniques are used to correct the malfunctioning catheters such as manipulator techniques, laparoscopic repositioning with tip suturing, omentectomy and omentopexy. In this article, we are proposing two cases, which had been referred by peritoneal catheter malfunctioning and then received a new method of surgery successfully and didn't have any complications after 36 months follow up. This method could simplify the procedure of operation and urachus ligament and reduce time and cost of the process.

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“…Jinari et al. 16 fixed the catheter at 2 cm below the upper incision and 2–3 cm under the pouch. The fixation site that Guoqin Lu et al.…”

Section: Discussionmentioning

confidence: 99%

Identification of the appropriate fixation site to avoid peritoneal catheter migration based on a mechanical analysis

et al. 2017

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Aim: To conduct mechanical analysis on the relationship between abdominal wall fixation point and the displacement of catheter top, and establish the finite element model for the complex forces and conditions that the catheter wears in human abdominal cavity, in order to provide the scientific basis for optimizing the catheter position in abdominal wall fixation method.Methods: Using the PIPE59 finite elements to divide units, and taking the lower part of catheter, that is, below interior polyester cuff to simulate and compute the displacement formula.Results: The whole model includes a total of 1701 units. Periodic load was used to simulate the dynamic pressure that peritoneal dialysis catheter gets in abdominal cavity. The load direction was perpendicular to the catheter axis. We used pressure amplitude, duration and frequency as the boundary conditions, and adjusted the fixation point of the catheter lower part at the same time, thus calculating the extreme displacement value of the catheter top end with changing parameter conditions. We also did fitted regression on the results and obtained the displacement formula: y = 0.2 × 0.87x (y: the end displacement of peritoneal dialysis catheter, x: the distance between fixation point and the interior polyester cuff), R2: .982. Simulation the catheter maximal displacement on flat surface demonstrated that additional catheter fixation at the site of 9 cm or more below the internal cuff significantly restricted the catheter migration.Conclusions: The optimal position of fixation point in peritoneal dialysis is about 9 cm away from the interior polyester cuff.

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Minilaparotomy Salvage of Malfunctioning Catheters in Peritoneal Dialysis

Abstract: ♦ Background: Catheter malfunction is a common and significant complication during peritoneal dialysis (PD). We developed a minilaparotomy procedure to rescue malfunctioning catheters and to prevent recurrence of malfunction.

Cited by 14 publications

References 12 publications

Minilaparotomy for malfunctioning peritoneal dialysis catheter by nephrologists: experiences at two centers

Minilaparotomy for malfunctioning peritoneal dialysis catheter by nephrologists: experiences at two centers

Catheter Fixation Behind the Urachus: A Novel Laparoscopic Technique to Revise Malfunctioning Peritoneal Dialysis Catheters

Identification of the appropriate fixation site to avoid peritoneal catheter migration based on a mechanical analysis

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