Primary laparoscopic placement of peritoneal dialysis catheters in children and young adults

Lessin, Marc S.; Luks, François I.; Brem, Andrew S.; Wesselhoeft, Conrad

doi:10.1007/s004649901198

Cited by 46 publications

(48 citation statements)

References 11 publications

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“…Although studies in adults, including RCTs, have shown an improved catheter survival rate and a lower incidence of infections and leaks subsequent to the introduction of laparoscopic placement (35,36), many studies in children have failed to show such a relationship (10,37,38). As for omentectomy, the procedure is performed in 60%-80% of PD catheter placements in children (39), and many studies have shown a significant reduction of catheter occlusion when routine omentectomy was performed (11,40).…”

Section: Discussionmentioning

confidence: 99%

“…Most published studies on PD access revision in children are limited by small sample size, and many show conflicting results (6)(7)(8)(9)(10)(11). Because there is a paucity of published experiences on the frequency of, risk factors for, and outcomes associated with PD catheter revision in children, we used the International Pediatric Peritoneal Dialysis Network (IPPN) database to evaluate these issues in a large cohort of pediatric patients receiving chronic PD.…”

Section: Introductionmentioning

confidence: 99%

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Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

Borzych-Dużałka¹,

Aki²,

Azócar³

et al. 2016

CJASN

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Background and objectives Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Results In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of followup, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P,0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk of technique failure compared with infectious causes (hazard ratio, 1.95; 95% confidence interval, 1.20 to 2.30; P=0.03).Conclusions Peritoneal dialysis catheter revisions are common in pediatric patients on peritoneal dialysis and complicate provision of chronic peritoneal dialysis. Attention to potentially modifiable risk factors by pediatric nephrologists and pediatric surgeons should be encouraged.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

Borzych-Dużałka¹,

Aki²,

Azócar³

et al. 2016

CJASN

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“…The proven benefits of laparoscopy seem to be especially applicable to patients with chronic disease like cirrhosis of liver. 22 …”

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confidence: 99%

“…3 They reported fewer rates of wound infection and wound bleeding in the laparoscopic group. Many other laparoscopic procedures including laparoscopic liver resections for hepatocellular carcinomas 21,22 and laparoscopic ultrasound with radiofrequency ablation are now routinely done in cirrhotic patients in some centers.…”

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confidence: 99%

Role and Advantages of Laparoscopic Surgery in Liver Cirrhosis

Gupta¹

2011

WJOLS

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Liver cirrhosis has always been associated with operative morbidity and mortality because of associated coagulopathies, nutritional disorders and portal hypertension. Laparoscopic surgery has changed the thinking and now liver cirrhosis is not a contraindication for mild to moderate liver cirrhosis patients.1 This article's review studies done by operating laparoscopically on patients with liver cirrhosis and the methods with which the complications are avoided by laparoscopy during various surgeries and also in the diagnosis and management of cirrhosis of liver.Keywords: Laparoscopy, Cirrhosis, Portal hypertension, Laparoscopic surgery in cirrhosis, Cirrhosis and laparoscopy, Surgical procedures in cirrhosis. REVIEW ARTICLE ABSTRACT BACKGROUND

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“…The benefits of this method are multiple, including simplicity, low costs, better blood pressure control, fewer dietary restrictions, increased patients' independence, decreased transfusions, and no need for anticoagulation [1]. The disadvantages of PD are peritonitis, exit site infections, tunnel infections, hernias, dialysis fluid leakage, catheter mechanical obstruction with outflow complication and catheter dislodgement, and external cuff extrusion [2,3].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic interventions in children on peritoneal dialysis

Szczepańska¹,

Korlacki²,

Szprynger³

et al. 2010

Videosurgery and Other Miniinvasive Techniques

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Primary laparoscopic placement of peritoneal dialysis catheters in children and young adults

Abstract: This minimal access technique for primary placement of peritoneal dialysis catheters includes securing of the catheter tip in a dependent location and omentectomy. It allows nearly immediate use of the catheter, leads to a minimal hospital stay, and has acceptable long-term patency.

Cited by 46 publications

References 11 publications

Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

Role and Advantages of Laparoscopic Surgery in Liver Cirrhosis

Laparoscopic interventions in children on peritoneal dialysis

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