New Acute Peritoneal Dialysis Technique: Wire-Guide Insertion and Long-Term Indwelling of Peritoneal Catheter

Nakanishi, Takeshi; Yanase, Masahiro; Fujii, Masamitsu; Tanaka, Yasue; Orita, Yoshimasa; Abé, Hiroshi

doi:10.1159/000183228

Cited by 12 publications

(3 citation statements)

References 6 publications

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“…Wire-guided percutaneous placement of an indwelling PDC has been described since 1984–1985 (32-35). To date, there are at least 20 other published reports on bedside percutaneous PDC insertion in the English literature, mostly retrospective cohort studies (6-16,22,36-43).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

et al. 2015

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♦ Background: The percutaneous Seldinger method of peritoneal dialysis catheter (PDC) insertion has gained favor over recent years whereas traditionally it was reserved for patients considered not fit for general anesthesia. This blind technique is believed to be less safe, and is hence avoided in patients with previous laparotomy incisions. Reports on the success of this method may therefore be criticized for selection bias. In those with no prior abdominal surgery the optimal method of insertion has not been established. ♦ Methods: We retrospectively reviewed the outcomes of first-time PDC placements comparing the percutaneous (group P) and surgical (group S) insertion techniques in patients without a history of previous abdominal surgery in a single center between January 2003 and June 2010. We assessed catheter survival at 3 and 12 months postinsertion and compared complication rates between the two groups. ♦ Results: A total of 63 percutaneous and 64 surgical catheter insertions were analyzed. No significant difference was noted in catheter survival rates between group P and group S (86.2% vs 80% at 3 months, p = 0.37; and 78.3% vs 71.2% at 12 months, p = 0.42 respectively). Early and overall peritonitis rates were similar (5% vs 5.3%; p = 1, and 3.5 vs 4.9 episodes per 100 patient-months; p = 0.13 for group P and group S respectively). There were also no significant differences between the two groups in exit site leaks (15.9% in group P vs 6.3% in group S; p = 0.15), poor initial drainage (9.5% in group P vs 10.9% in group S, p = 0.34) or secondary drainage failure (7.9% in group P vs 18.8% in group S, p = 0.09).

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Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

et al. 2015

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“…The indwelling peritoneal catheter was first developed by Henry Tenckhoff in 1968 and was placed using an open surgical technique (12). The percutaneous technique of catheter placement was described as early as 1984 (13). We compared the blind, bedside, midline, percutaneous technique for PD catheter insertion between diabetics and non-diabetics in 245 patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early Mechanical and Infective Complications in First Time Blind, Bedside, Midline Percutaneous Tenckhoff Catheter Insertion with Ultra-Short Break-in Period in Diabetics and Non-Diabetics: Setting New Standards

et al. 2016

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♦ BACKGROUND: There are no large studies that have examined ultra-short break-in period with a blind, bedside, midline approach to Tenckhoff catheter insertion. ♦ METHODS: Observational cohort study of 245 consecutive adult patients who underwent percutaneous catheter insertion for chronic peritoneal dialysis (PD) at our center from January 2009 to December 2013. There were 132 (53.9%) diabetics and 113 (46.1%) non-diabetics in the cohort. ♦ RESULTS: The mean break-in period for the percutaneous group was 2.68 ± 2.6 days. There were significantly more males among the diabetics (103 [78%] vs 66 [58.4%], p = 0.001). Diabetics had a significantly higher body mass index (BMI) (23.9 ± 3.7 kg/m vs 22.2 ± 4 kg/m, p < 0.001) and lower serum albumin (33.1 ± 6.3 g/L vs 37 ± 6 g/L, p < 0.001) compared with non-diabetics. Poor catheter outflow was present in 6 (4.5%) diabetics and 16 (14.2%) non-diabetics (p = 0.009). Catheter migration was also significantly more common in the non-diabetic group (11 [9.7%] vs 2 [1.5%], p = 0.004). Primary catheter non-function was present in 17(15%) of the non-diabetics and in 7(5.3%) of the diabetics (p = 0.01). There were no mortality or major non-procedural complications during the catheter insertions. Among patients with 1 year of follow-up data, catheter survival (93/102 [91.2%] vs 71/82 [86.6%], p = 0.32) and technique survival (93/102 [91.2%] vs 70/82 [85.4%], p = 0.22) at 1 year was comparable between diabetics and non-diabetics, respectively. ♦ CONCLUSIONS: Percutaneous catheter insertion by practicing nephrologists provides a short break-in period with very low mechanical and infective complications. Non-diabetic status emerged as a significant risk factor for primary catheter non-function presumed to be due to more patients with lower BMI and thus smaller abdominal cavities. This is the first report that systematically compares diabetic and non-diabetic patients.

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“…CAPD catheter placement with direct visualization via laparotomy has been the conventional mainstay of access placement, but it necessitates the availability of surgical and anaesthetic services and increases the cost and duration of the hospital stay. Catheter placement by the percutaneous technique was described as early as 1984, 3 and over the last decade has been increasingly used by trained doctors with similar success rates as open placement, reducing incision size and the duration of hospital stay, 4 as well as obviating the need for specialist anaesthetic or surgical services.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous continuous ambulatory peritoneal dialysis (CAPD) catheter insertion – a preferred option for developing countries

et al. 2010

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Continuous ambulatory peritoneal dialysis (CAPD) as a modality of renal replacement therapy in patients with chronic kidney disease stage 5 (CKD 5) has the advantage of being a home-based therapy and is a preferred option in patients with inadequate access to haemodialysis and transplantation facilities and in those infected with HIV and other blood-borne viruses. While open surgical CAPD catheter placement has been the conventional mainstay of access placement, percutaneous techniques are being increasingly used with similar success rates. We report our experience over the past two years with blind insertion of the swan neck percutaneous double-cuffed Tenckhoff CAPD catheter using a trocar. There was considerable decrease in hospital stay and surgical costs. There was only one major complication of injury to the jejunal mesenteric artery requiring emergency laparotomy in one patient. In three patients, drain of peritoneal fluid was inadequate, presumably due to omental wrapping around the in-dwelling catheter, and required surgical removal of the omentum.

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New Acute Peritoneal Dialysis Technique: Wire-Guide Insertion and Long-Term Indwelling of Peritoneal Catheter

Cited by 12 publications

References 6 publications

Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

Comparison of Early Mechanical and Infective Complications in First Time Blind, Bedside, Midline Percutaneous Tenckhoff Catheter Insertion with Ultra-Short Break-in Period in Diabetics and Non-Diabetics: Setting New Standards

Percutaneous continuous ambulatory peritoneal dialysis (CAPD) catheter insertion – a preferred option for developing countries

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