Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department

Radtke, Josephine; Schild, Raphael; Reismann, Marc; Ridwelski, Robert-Richard; Kempf, Caroline; Nashan, Bjoern; Rothe, K; Koch, Martina

doi:10.1016/j.jpedsurg.2017.06.028

Cited by 18 publications

(6 citation statements)

References 22 publications

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“…21 Revision rates were similarly high with up to 42% of patients requiring some type of revision. 21 A catheter that is more resilient to external obstruction and dislodgment is likely to further improve outcomes in this fast-growing procedure.…”

Section: Discussionmentioning

confidence: 99%

“…3 Similar patterns of catheter obstruction were seen for peritoneal dialysis (PD) catheters. 21 In one study that examined 6-month outcomes of PD catheters, catheter obstruction/dysfunction was a major complication after insertion occurring in up to 30% of cases. 21 Revision rates were similarly high with up to 42% of patients requiring some type of revision.…”

Section: Discussionmentioning

confidence: 99%

“…21 In one study that examined 6-month outcomes of PD catheters, catheter obstruction/dysfunction was a major complication after insertion occurring in up to 30% of cases. 21 Revision rates were similarly high with up to 42% of patients requiring some type of revision. 21 A catheter that is more resilient to external obstruction and dislodgment is likely to further improve outcomes in this fast-growing procedure.…”

Section: Discussionmentioning

confidence: 99%

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Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure

Bishawi

Feiger

Kurupassery

et al. 2020

J Clin Interv Radiol ISVIR

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Objective Efficient flow of fluids through drainage/infusion catheters is affected by surrounding tissue, organ compression, and scar tissue development, limiting or completely obstructing flow through drainage holes. In this work, we introduce a novel three-dimensional (3D) drainage catheter with protected side holes to reduce flow blockages. We then compare its drainage performance to standard straight and pigtail catheters using computer-generated catheter designs and flow analysis software. Methods Drainage performance was computed as flow rate through the catheter for a given pressure differential. Each catheter contained drainage holes on the distal (insertion) end and a single outlet (hub) hole open to atmosphere. Computational fluid dynamics using ANSYS AIM 18.2 was used to simulate flow through the catheter and examine drainage performance based on variations to the following parameters: (1) side hole shape, (2) cross-sectional area of the catheters, (3) number of side holes, and (4) cross-sectional area of the side holes. Results Drainage through the newly introduced catheter in all simulations was nearly identical to standard pigtail and straight catheters. While working to optimize the 3D catheter design, we found that the changes in side hole shape and side hole cross-sectional area had little effect on the total flow rate through the catheters but had a large impact on flow rate through the side hole nearest to the hub (proximal hole). Additionally, the majority of flow in all catheters occurred at the most proximal 1 to 3 side holes closest to hub, with relatively little flow occurring at side holes more distally located (closest to insertion end). The 3D catheter demonstrated no changes in flow characteristics when the coiled segment was occluded, giving it an advantage over other catheter types when the catheter is compressed by surrounding tissue or other external obstruction. Conclusions The majority of fluid flow in catheters with a diameter of 4.67 mm (14 Fr) or smaller occurred at the most proximal 1 to 3 side holes. A novel 3D coiled catheter design can protect these proximal holes from external blockage while maintaining drainage performance compared with standard straight and pigtail catheters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure

Bishawi

Feiger

Kurupassery

et al. 2020

J Clin Interv Radiol ISVIR

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“…There are reports indicating that partial omentectomy in some patients with catheter dysfunction contributes to the dialysis catheter being more functional. On the contrary, in another clinical study involving 154 patients with peritoneal dialysis catheters, it was concluded that omentectomy had no contribution to catheter occlusion[ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Is omentectomy necessary in the treatment of benign or malignant abdominal pathologies? A systematic review

Atay¹,

Dılek²

2021

WJGS

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BACKGROUND The omentum is an organ that is easily sacrificed during abdominal surgery. The scope of omentectomy and whether a routine omentectomy should be performed are still unknown. AIM To review the literature in order to determine the physiological functions of the omentum and the roles it plays in pathological events in order to reveal the necessity for removal and preservation of the omentum. METHODS A clinical review of the English language literature based on the MEDLINE (PubMed) database was conducted using the keywords: “abdomen”, “gastrointestinal”, “tumor”, “inflammation”, “omental flap”, “metastasis”, “omentum”, and “omentectomy”. In addition, reports were also identified by systematically reviewing all references in retrieved papers. RESULTS The omentum functions as a natural barrier in areas where pathological processes occur in the abdominal cavity. The omentum limits and controls inflammatory and infectious pathologies that occur in the abdomen. It also aids in treatment due to its cellular functions including lymphatic drainage and phagocytosis. It shows similar behavior in tumors, but it cannot cope with increasing tumor burden. The stage of the disease changes due to the tumor mass it tries to control. Therefore, it is considered an indicator of poor prognosis. Due to this feature, the omentum is one of the first organs to be sacrificed during surgical procedures. However, there are many unknowns regarding the role and efficacy of the omentum in cancer. CONCLUSION The omentum is a unique organ that limits and controls inflammatory processes, foreign masses, and lesions that develop in the abdominal cavity. Omental flaps can be used in all anatomical areas, including the thorax, abdomen, pelvis, and extremities. The omentum is an organ that deserves the title of the abdominal policeman. It is generally accepted that the omentum should be removed in cases where there is tumor invasion. However, the positive or negative contribution of omental resection in the treatment of abdominal pathologies should be questioned.

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“…The advantage of our technique is that the incidence of postoperative complications such as catheter displacement and leakage of omentum wrap are minimal [ 2 ]. When both outflow and inflow failures are observed, especially in conjunction with abdominal pain, the possibility of obstruction by the abdominal viscera, including the wrap of omentum [ 3 , 4 ], hemorrhagic corpus luteum [ 5 ], the fimbriae and infundibulum of the oviduct [ 6 ], fallopian tube [ 7 ], fibrin sheath [ 1 ], appendix [ 8 ], small intestine [ 9 ], sigmoid colon wall [ 10 ]. Omental capture was suspected, and diagnostic laparoscopy was performed.The omentum was not involved,but the sigmoid mesocolon tightly covered the catheter and blocked the drainage holes.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal dialysis catheter malfunction caused by wrapping of the catheter by the sigmoid mesocolon: a case report

Shao

Zhang

2021

Renal Failure

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Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department

Cited by 18 publications

References 22 publications

Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure

Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure

Is omentectomy necessary in the treatment of benign or malignant abdominal pathologies? A systematic review

Peritoneal dialysis catheter malfunction caused by wrapping of the catheter by the sigmoid mesocolon: a case report

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