Peritoneal Vicenza “Short” Catheter Outcomes and Comparison with International Society for Peritoneal Dialysis Guidelines

Abstract

<b><i>Introduction:</i></b> A well-functioning peritoneal catheter is key to success of peritoneal dialysis (PD). The Vicenza “short” catheter is a modified Tenckhoff catheter with a shorter intraperitoneal segment. The aim of this study was to evaluate the incidence of catheter-related complications and catheter survival rate using the Vicenza “short” catheter, according to the goals suggested by the International Society for Peritoneal Dialysis (ISPD) guidelines. Second, we compared insertion techniques used in our center. <b><i>Methods:</i></b> This is a retrospective cohort, single-center study analyzing incident PD patients undergoing Vicenza “short” peritoneal catheter placement between January 1, 2015, and December 31, 2019. As clinical outcomes, we evaluated catheter patency at 12 months, exit-site/tunnel infection and peritonitis within 30 days of catheter insertion, visceral injury, or significant hemorrhage during the procedure, in accordance with ISPD guidelines. <b><i>Results:</i></b> The percentage of patency at 12 months for all catheter insertion methods was 88.91%, and the percentage for laparoscopic placement was 93.75%. The exit-site/tunnel infection and peritonitis occurring within 30 days of catheter insertion were, respectively, 0.75% and 2.2%; the visceral injury leading to intervention was 0.75%. We did not have any case of significant hemorrhage. All results were in line with ISPD guidelines. <b><i>Conclusion:</i></b> We conclude that the Vicenza “short” catheter is a suitable device for peritoneal access. The implantation procedure is safe and easy to perform, and both nephrologists and surgeons can do it. A confident use and a proper implantation of the Vicenza “short” catheter help achieve the clinical ISPD goals for the PD access procedure in terms of catheter survival and complication rates.

A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan

“…17 Manani et al compared their original catheter outcomes to ISPD guideline criteria in 2022. 18 They reported that catheter patency at 12 months was 88.5% for laparotomy and 93.8% for laparoscopic surgery cases. Recently, a review of PD catheter placement techniques for improving catheter function and clinical outcomes was published.…”

“…4 Manani et al reported that the occurrence rate of ESTIs within 30 days was only 0.75%. 18 The high occurrence rate of ESTIs in Japan may be related to perioperative catheter care. Although the 2023 ISPD guidelines for catheter-related infections have downgraded the recommendation, the guideline still recommended daily topical application of antibiotic cream or ointment to the catheter exit site.…”

Minimizing early catheter failure using a risk stratification model for peritoneal dialysis

“…Previous studies suggested that different catheter placement methods and catheter types are associated with catheter complications. 2,[10][11][12][13] However, little attention has been paid to the basic characteristics inherent to patients with early PD catheter failure, and there is no complete risk assessment program before PD catheterization at present. Thus, our study aimed to explore the population characteristics of PD patients with early catheter failure in our center, establish a risk stratification model, and propose a more suitable clinical procedure for PD catheterization in our center.…”

“…The need for catheter replacement following catheter‐related complications not only increased the complexity of patients' treatment but also reduced the acceptance of PD. Previous studies suggested that different catheter placement methods and catheter types are associated with catheter complications 2,10–13 . However, little attention has been paid to the basic characteristics inherent to patients with early PD catheter failure, and there is no complete risk assessment program before PD catheterization at present.…”