Peritoneal dialysis catheter placement technique and complications

Abstract

Background. This review describes the peritoneal dialysis (PD) catheter implantation techniques for the treatment of PD. The PD catheter-related complications still cause significant morbidity and mortality, resulting in the necessity to switch to haemodialysis (HD) treatment.Methods. Several catheter insertion techniques, using an open surgical approach, laparoscopic and percutaneous techniques have been employed, with their specific early and late complications and failure rates.Results. Despite the similar outcomes of open surgical versus laparoscopic techniques from randomized studies, the laparoscopic insertion has the major advantage of correct catheter positioning in the lower abdomen, with the possibility of adhesiolysis. The minimal invasive percutaneous insertion bears the risk of bowel perforation and catheter malpositioning, and the outcome of this technique is strongly related to the experience of the surgeon. The major complications of these implantation techniques, like bleeding, dialysate leakage and catheter malpositioning, and their management are discussed in our study. Late peritonitis remains the major drawback of PD treatment, with the need of temporary or permanent changeover to the HD treatment in 10% of the patients.Conclusions. Enrichment of the physician's interest and experience, along with a multidisciplinary approach to outline the optimal strategy of PD-catheter insertion and complication of the treatment, may improve the patients’ survival and decrease the morbidity.

Mechanical Complications of Peritoneal Dialysis

“…Early complications included leakage, catheter dysfunction, hemoperitoneum, while late complications are defined by hernias, pleuroperitoneal leaks and sleeve externalization [9]- [11].…”

A 2-Year Follow-Up Study of Patients On Continuous Ambulatory Peritoneal Dialysis (CAPD) In Specialized Hospitals In Dhaka, Bangladesh

“…Early-onset complications include exit site leak, catheter malposition, hemoperitoneum, right-sided hydrothorax and ultrafiltration failure (UFF). The late-onset complications include abdominal hernia, scrotal swelling, encapsulated peritonitis and catheter cuff protrusion 5 . In this study, 30.8% patient fell pain during dialysis, because patient also may describe the pain which was related to other abdominal causes.…”

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

“…Among these techniques laparoscopic peritoneal dialysis catheter insertion had been reported to be the method of choice with low visceral injury, bleeding, incisional hernia and catheter disfunction risks. [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.…”