Smaller Insertion Angle of Tenckhoff Catheter Increases the Chance of Catheter Migration in CAPD Patients

Hwang, Shang Jyh; Chang, Jer Ming; Chen, Hung Chun; Tsai, Ming Kwei; Tsai, Jason; Hsu, Chin Huei; Hsiao, Pin Wu; Tsai, Chiu Yueh; Guh, Jinn Yuh; Lai, Yung Hsiung

doi:10.1177/089686089801800415

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Some studies have shown that the excessive subcutaneous angle of bending of the catheter may cause a large elasticity and subsequently lead to the migration of PD catheter abdominal segment, which is also one of the possible reasons for simple migration. In this study, we only observed one case with simple displacement in our center, probably due to the fact that surgeons had noticed this problem in the catheterization [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Reducing the occurrence rate of catheter dysfunction in peritoneal dialysis: a single-center experience about CQI

Liu

et al. 2018

Renal Failure

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To reduce the occurrence rate of peritoneal dialysis (PD) catheter dysfunction caused by catheter displacement or plugging, this study screened all patients with peritoneal dialysis catheterization from 2002 to 2015 from the Third Xiangya Hospital of Central South University. There were 256 patients before continuous quality improvement (CQI) (from 2002 to 2007) and 813 patients after CQI (from 2008 to 2015). The occurrence rate of catheter dysfunction was 5.9% in the preCQI group: seven cases were associated with peritonitis, six cases were involved in omentum wrapping, one case was blocked by oviduct, and one case was blocked by blood clot. Through PDCA (plan-do-check-act) four-step of CQI, the following measures were adopted: (1) Preoperative: treat complications, enema and urine catheterization (2) Intraoperative: strengthen analgesia, Lower the insert position of catheter to 7.5 ∼ 8.5 cm above the pubic symphysis, extending the straight distance of catheter in rectus abdominis and decrease the times of peritoneal dialysis catheter implantation. (3) Postoperative: strengthen the training of nurses, patients and their families. (4) strengthen anticoagulation therapy during peritonitis treatment. (5) use laparoscopic technology for refractory patients, and so on. The occurrence of catheter dysfunction was 1.5% in the postCQI group (p < 0.05): two cases were associated with peritonitis, ten cases were involved in omentum wrapping. The measures we adopted in CQI reduce the occurrence rate of catheter displacement or plugging in peritoneal dialysis.

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Section: Discussionmentioning

confidence: 99%

Reducing the occurrence rate of catheter dysfunction in peritoneal dialysis: a single-center experience about CQI

Liu

et al. 2018

Renal Failure

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“…In the literature, case-series suggest that the laparoscopic insertion technique is to be preferred over the open technique. A higher incidence of exit-site infections in the open group (6.3-41% [ 22 - 25 ]) versus the laparoscopic group (2.5-18% [ 26 , 27 ]) is reported, as well as a higher incidence of catheter migration in the open group (7.6-17.1% [ 22 , 25 , 28 ] versus 1.3-5.4% [ 26 , 27 , 29 ]. No differences have been described between open and laparoscopic PD catheter insertion regarding the incidence of peritonitis, 2.9-31% [ 22 - 25 ] and 2.5-31% [ 26 , 27 , 30 ], respectively.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open peritoneal dialysis catheter insertion, the LOCI-trial: a study protocol

et al. 2011

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BackgroundPeritoneal dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemodialysis. Key to successful PD is the presence of a well-functioning dialysis catheter. Several complications, such as in- and outflow obstruction, peritonitis, exit-site infections, leakage and migration, can lead to catheter removal and loss of peritoneal access. Currently, different surgical techniques are in practice for PD-catheter placement. The type of insertion technique used may greatly influence the occurrence of complications. In the literature, up to 35% catheter failure has been described when using the open technique and only 13% for the laparoscopic technique. However, a well-designed randomized controlled trial is lacking.Methods/DesignThe LOCI-trial is a multi-center randomized controlled, single-blind trial (pilot). The study compares the laparoscopic with the open technique for PD catheter insertion. The primary objective is to determine the optimum placement technique in order to minimize the incidence of catheter malfunction at 6 weeks postoperatively. Secondary objectives are to determine the best approach to optimize catheter function and to study the quality of life at 6 months postoperatively comparing the two operative techniques.DiscussionThis study will generate evidence on any benefits of laparoscopic versus open PD catheter insertion.Trial registrationDutch Trial Register NTR2878

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“…Published reports say that the angle of the exit site with respect to the midline can influence the rate of displacement (11). That problem may have been present, but our surgical team has been the same since the beginning, and the method of implantation method had not changed.…”

Section: Discussionmentioning

confidence: 99%

Lower Malfunction Rate with Self-Locating Catheters

et al. 2001

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Objective We analyzed malfunction rates (obstruction, omental wrapping, displacement) and catheter survival for self-locating catheters as compared with other Tenckhoff catheter designs. Patients and Methods We conducted our survey at two centers, prospectively studying all self-locating catheters implanted from May 1997 to October 2000 and used for peritoneal dialysis (PD). Tenckhoff catheters of other designs used previously in our units were used as the control group. We analyzed removal causes and catheter survival. Results We studied 173 catheters (105 self-locating catheters, 53 straight catheters, and 15 coiled catheters) implanted in 139 patients (43% of them women) with a mean age of 53 ± 14 years. The analysis of catheter removal showed that 3 of 105 self-locating catheters, 3 of 15 coiled catheters, and 17 of 53 straight catheters were removed owing to malfunction (c 2: p = 0.0000). Kaplan–Meier curves showed that the bulk of removals for malfunction occurred within the first 3 months after PD start. The group of self-locating catheters showed better survival (log-rank: p = 0.0009). Other causes for catheter removal included peritonitis ( n = 22), exit-site infection alone ( n = 4), and end of PD treatment ( n = 66). No significant differences were seen in the annual peritonitis rate (straight-tip: 0.955 ± 2.315 episodes annually; coiled-tip: 0.651 ± 0.864 episodes annually; self-locating: 0.720 ± 1.417 episodes annually; t-test: p > 0.400). No gut or bladder perforations were observed. Conclusion In our survey, self-locating catheters were associated with better survival and fewer removals for malfunction than were Tenckhoff catheters of other designs.

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Smaller Insertion Angle of Tenckhoff Catheter Increases the Chance of Catheter Migration in CAPD Patients

Cited by 7 publications

References 8 publications

Reducing the occurrence rate of catheter dysfunction in peritoneal dialysis: a single-center experience about CQI

Reducing the occurrence rate of catheter dysfunction in peritoneal dialysis: a single-center experience about CQI

Laparoscopic versus open peritoneal dialysis catheter insertion, the LOCI-trial: a study protocol

Lower Malfunction Rate with Self-Locating Catheters

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