Preliminary report: nephroscope-assisted “pulling-thread” technique for placement of peritoneal dialysis catheter

Abstract

Background: Several catheter placement procedures have been described for initiation of peritoneal dialysis, including percutaneous insertion, open surgery, and laparoscopic surgery. However, the optimal approach to catheter placement for peritoneal dialysis remains controversial, because each procedure has specific advantages and disadvantages. Patients and methods: From June 2010 to October 2014, we performed a nephroscope-assisted "pulling-thread" technique for placement of peritoneal dialysis catheters in 46 patients with end-stage renal disease at our medical center. We retrospectively reviewed the operation-related data, early catheter-related complications during the first month after placement, and longterm technical catheter survival. Results: Catheters in all 46 patients were placed precisely in a single step during surgery. The mean operative time was 63.0 ± 18.2 minutes, and no intra-operative complications occurred in any patient. Early catheter-related complications included only exit-site infection (n = 2; 4.3%) and catheter obstruction (n = 2; 4.3%). There was a mean follow-up period of 18.3 ± 12.7 months. The probability of catheter survival at 1 year was 97.1% and at 2 years was 80.1%. Conclusion: Our technique has the advantages of simplicity, safety, minimal equipment, low early catheter-related complication rate, and favorable long-term catheter outcome, making it ideal for patients with end-stage renal disease.