Percutaneous versus Surgical Insertion of PD Catheters in Dialysis Patients: A Meta-Analysis

Boujelbane, Lamya; Fu, Ning; Chapla, Kevin; Melnick, David M.; Redfield, Robert; Waheed, Sana; Yevzlin, Alexander S.; Shin, Juneseuk; Astor, Brad C.; Chan, Micah R.

doi:10.5301/jva.5000439

Cited by 52 publications

(71 citation statements)

References 22 publications

(49 reference statements)

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“…In addition, because of avoiding a large peritoneal incision and the need for suturing, the percutaneous insertion can save much more time during the procedure [37,38]. Some studies have reported that the mechanical complication rate of percutaneous insertion was similar to that of surgical and laparoscopic [10,15,36,39], the infectious complication rate was lower [10,39,40], and survival was better [36]. Similar conclusions have been drawn in this study.…”

Section: Discussionsupporting

confidence: 81%

Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

Xie

Zhou

Cao

et al. 2020

Preprint

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Background. A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion , although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods. 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results. Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions. Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

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Section: Discussionsupporting

confidence: 81%

Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

Xie

Zhou

Cao

et al. 2020

Preprint

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show abstract

“…Moreover, the conventional Seldinger technique uses a blind puncture process, so it is difficult to place the catheter accurately and there is risk of organ injury and hemorrhage. Some studies have even found no advantages of percutaneous catheterization over traditional open surgery or laparoscopic surgery regarding catheter‐related complications and catheter survival duration, 12‐15 suggesting the need for further improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Medani et al reported a 90% success rate, defined as maintenance of normal catheter function for 2‐4 weeks, using the blind Seldinger technique in patients receiving catheterization for the first time without a history of abdominal surgery, similar to that of a parallel surgical placement group 16 . However, van Laanen et al reported that only 77% of patients maintained normal catheter function for 2 weeks after surgical insertion (failure rate of 23%), 11 and several other randomized control trials have also reported relatively high (16% to 30%) failure rates for catheterization by surgical laparotomy 12‐14 . Thus, all the previous techniques show substantially greater failure rates (up to 30%) than ultrasound‐guided percutaneous peritoneal dialysis catheter placement using a multifunctional bladder paracentesis trocar (around 4% failure).…”

Section: Discussionmentioning

confidence: 99%

“…16 However, van Laanen et al reported that only 77% of patients maintained normal catheter function for 2 weeks after surgical insertion (failure rate of 23%), 11 and several other randomized control trials have also reported relatively high (16% to 30%) failure rates for catheterization by surgical laparotomy. [12][13][14] Infection is the main cause for catheter removal. 19 Although none of the patients in our study received antibiotics to prevent peritonitis, there were no such cases.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar: A modified percutaneous PD catheter placement technique

Ding

Xue

2020

Seminars in Dialysis

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Background To evaluate the efficacy and safety of ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar. Methods A retrospective review of 103 ESRD patients receiving percutaneous PD catheter insertion using a multifunctional bladder paracentesis trocar under ultrasound guidance at a single center between May 2016 and May 2018. Mechanical complications and catheter survival were evaluated over a 12‐month follow‐up. Result Catheterization using this technique required only 10‐30 minutes from the beginning of local anesthesia to the end of skin suture at the puncture site (mean 18 ± 7 minutes) and an incision length of 2‐4 cm. Moreover, only four of 103 cases required catheter removal due to poor drainage within one month after surgery, with a success rate of 96.19%. Among failures, omentum wrapping was cause in two cases, catheter displacement in one case, and protein clot blockage in one case, while there were no instances of organ injury, severe hemorrhage, peritubular leakage, hernia, peritonitis, or exit infection within one month of PD catheter insertion. Catheter survival at 1 year was 92.2%. Conclusion Percutaneous PD catheter insertion using a multifunctional bladder paracentesis trocar and ultrasound guidance is a feasible technique for ESRD patients.

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“…[14,15] On the other hand various meta-analysis have shown that all insertion methods have been comparable and there were no significant differences among different methods. [16][17][18] Currently; laparoscopic insertion of the peritoneal dialysis catheter is prefered due to better evaluation of the intraabdominal region, catheter fixation capability and availability of adhesiolysis upon observation. [19,20] However catheter migration is still a big problem in peritoneal dialysis catheter insertion and therefore in recent years catheter fixation to the abdominal wall have been developed to prevent this complication.…”

Section: Discussionmentioning

confidence: 99%

Sedation anesthesia technique for the insertion of laparoscopic fixated peritoneal dialysis catheter using carbondioxide

Zumrutdal¹

2018

Laparosc Endosc Surg Sci

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Percutaneous versus Surgical Insertion of PD Catheters in Dialysis Patients: A Meta-Analysis

Cited by 52 publications

References 22 publications

Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

Ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar: A modified percutaneous PD catheter placement technique

Sedation anesthesia technique for the insertion of laparoscopic fixated peritoneal dialysis catheter using carbondioxide

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