Respecting shape memory to optimize peritoneal dialysis catheter outcomes

Briggs, Victoria; Shrestha, Badri Man; Wilkie, Martin

doi:10.1038/ki.2014.238

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…A meta-analysis by Shrestha et al showed superior outcomes of laparoscopic PD catheter insertion compared to open and lower catheter migration rates. 5,9,10 These studies all describe advanced laparoscopic techniques as being ometopexy, selective adhesionolysis or omentectomy. Few studies describe suture fixation of the PD catheter in the advanced laparoscopic group and Harissis et al, describes a one port catheter insertion technique with an abdominal fixation technique similar to our study 7,11 but very few studies show advantages with suture fixation, but large studies are lacking.…”

Section: Discussionmentioning

confidence: 99%

A modified laparoscopic peritoneal dialysis insertion technique, the ‘one scar technique’ can minimise short and long term complications: A retrospective cohort study

Musbahi¹,

Kanakala²

2020

J Vasc Access

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Introduction: Peritoneal dialysis is a renal replacement therapy that has advanced in technique over the last few decades. In this study, we describe a novel method for laparoscopic peritoneal dialysis catheter insertion and fixation and compare its outcome to standard laparoscopic insertion technique with better cosmetic outcome. Method: Peri-operative and follow up data was collected retrospectively for 184 patients undergoing peritoneal dialysis catheter insertion from September 2012 to September 2018. Results: The post-modification technique showed no difference in catheter blockage rates, incisional hernia or catheter replacement rates. A significant difference was found in catheter migration rate and exit site infections and overall complication rates, found to be lower using the new technique. Conclusion: A modification of the laparoscopic peritoneal dialysis technique is superior to standard laparoscopic insertion with a cosmetically more appealing outcome due to one visible.

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Section: Discussionmentioning

confidence: 99%

A modified laparoscopic peritoneal dialysis insertion technique, the ‘one scar technique’ can minimise short and long term complications: A retrospective cohort study

Musbahi¹,

Kanakala²

2020

J Vasc Access

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“…It is recognised that there are no differences in the outcomes when comparing different types of peritoneal catheters [28,29]. Shape memory of the peritoneal catheters has been implicated in the catheter migration process [30]. In a prospective randomised study, Lye and co-workers observed that the Swan neck confi guration resulted in a signifi cant reduction in the rate of exit-site infection [31].…”

Section: Discussionmentioning

confidence: 99%

Peritoneal catheter survival: The impact of unroofing

Barone¹

2017

Arch Clin Nephrol

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Background: Unroofi ng is a controversial procedure to avoid catheter removal in the treatment of the chronic exit site and tunnel infection, but is now rarely recommended. Here we aimed to evaluate the effects of the unroofi ng procedure on peritoneal catheter survival. Methods: From our database, we prospectively evaluated the outcome of 139 peritoneal catheters placed in 121 patients (1.14 catheters per patient, 73 female, 48 male) from 08-03-1993 to 12-31-2016. Twenty-three infected catheters needed surgical unroofi ng of the tunnel tract. We calculated the cumulative catheter survival rates (Kaplan-Meier) of 1) overall catheters and 2) not unroofed catheters, considering catheter removal as an endpoint. We also calculated 3) the unroofed catheter survival, considering the date of unroofi ng or catheter removal as the endpoint and, 4) continuity of the unroofed catheters post-unroofi ng, considering the unroofi ng date as if it were a new catheter and catheter removal as the endpoint. Likewise, we compared the survival of: a) unroofed catheters vs. continuity of the unroofed catheters and, b) no unroofed catheters vs. continuity of the unroofed catheters (Log-rank test) (signifi cance value P< 0.05). Results: 1) The overall catheter survival rates were 94%, 84%, 76%, 55%, 40% and 26% at 12, 36, 60, 84, 120 and 210 months respectively. 2) The not unroofed catheter survival rates were 93%, 83%, 77%, 59%, 44% and 44% at 12, 36, 60, 84, 120 and 210 months respectively. 3) The unroofed catheter survival rates were 84%, 53%, 31%, 23% and 9% at 12, 36, 60, 84 and 120 months respectively. 4) The post-unroofed catheters survival rates were 91%, 77%, 66%, 66%, 50% and 33% at 12, 36, 60, 84, 120 and 160 months respectively. We detected a statistical signifi cance when comparing unroofed catheters vs. continuity of the unroofed catheters and no statistical signifi cance was observed when comparing not unroofed catheters vs. continuity of the unroofed catheters post-unroofed. Conclusion: The overall catheter survival was satisfactory. Unroofi ng contributed signifi cantly in the lifespan of the catheters.

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“…Several publications have addressed the role of peritoneal catheter configuration (27) in preventing catheter migration and more recently the role of post-implantation X-ray parameters in predicting functional problems of swan neck peritoneal catheters (28, 29). The self-locating catheter allows a complete independence from many factors potentially influencing catheter tip migration, such as variations of the insertion technique and disruption of the catheter shape memory at the time of insertion.…”

Section: The Self-locating Pd Cathetermentioning

confidence: 99%

Type of Peritoneal Dialysis Catheter and Outcomes

et al. 2015

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In peritoneal dialysis (PD), a well-functioning catheter is of great importance, because a dysfunctional catheter may be associated with incidence of peritonitis, efficiency of dialysis, and to the overall quality of treatment, representing one of the main barriers to optimal use of PD. When considering the relationship between PD catheter type and outcomes, we should keep in mind the different types of available PD catheters, those that are most commonly used in clinical practice, and the available head-to-head comparisons in the literature. The main differences in PD catheter design include the number of cuffs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intraperitoneal tract (straight vs. coiled). The availability of the best catheter design and materials, along with a skillful management of PD access, may have the greatest impact on long-term patient outcome on PD. It is now established that the use of straight catheters may improve outcomes and technique survival, but further advances in PD catheter technology can potentially improve technique survival. The self-locating PD catheter is a well established device that has not been fully studied and it may represent, based on the available observational evidence and on the clinical experience, an already existing technological advance deserving further studies.

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Respecting shape memory to optimize peritoneal dialysis catheter outcomes

Cited by 7 publications

References 9 publications

A modified laparoscopic peritoneal dialysis insertion technique, the ‘one scar technique’ can minimise short and long term complications: A retrospective cohort study

A modified laparoscopic peritoneal dialysis insertion technique, the ‘one scar technique’ can minimise short and long term complications: A retrospective cohort study

Peritoneal catheter survival: The impact of unroofing

Type of Peritoneal Dialysis Catheter and Outcomes

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