A Comparative Analysis of Percutaneous and Open Surgical Techniques for Peritoneal Catheter Placement

Medani, Samar; Shantier, Mohamed; Hussein, Wael F.; Wall, Catherine; Mellotte, George

doi:10.3747/pdi.2011.00187

Cited by 63 publications

(93 citation statements)

References 33 publications

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“…To our knowledge, no previous studies reported comparisons of the two techniques after eliminating these confounding factors. We previously compared outcomes between the two methods in a more heterogeneous cohort of patients regardless of their surgical history (8). Whether previous abdominal surgery does indeed increase the risk of postoperative catheter related complications regardless of appropriate selection of catheter placement technique remains to be confirmed (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

“…Visceral injury, the major concern as a potential complication of this technique, is uncommon. We previously reported a comparative analysis of surgical versus percutaneous insertion of PDCs showing a trend towards better outcomes in the percutaneous group (8). We pointed out that potentially significant bias imposed by avoidance of the percutaneous method in a majority of the patients who had prior abdominal surgery is a major limitation of the study, as pre-existing adhesions in those patients selected for the surgical technique may have affected catheter function and hence outcomes.…”

mentioning

confidence: 99%

“…Surgical insertion via minimal laparotomy remains the most common technique of PDC placement (2)(3)(4), and in the United States, laparoscopic insertions account for at least a quarter of total PD access procedures (5). However, previous studies have shown encouraging outcomes of percutaneous insertion of PDCs, demonstrating favorable catheter survival and a good safety profile (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). There are few specific indications to recommend one technique over the other.…”

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confidence: 99%

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Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

et al. 2015

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♦ Background: The percutaneous Seldinger method of peritoneal dialysis catheter (PDC) insertion has gained favor over recent years whereas traditionally it was reserved for patients considered not fit for general anesthesia. This blind technique is believed to be less safe, and is hence avoided in patients with previous laparotomy incisions. Reports on the success of this method may therefore be criticized for selection bias. In those with no prior abdominal surgery the optimal method of insertion has not been established. ♦ Methods: We retrospectively reviewed the outcomes of first-time PDC placements comparing the percutaneous (group P) and surgical (group S) insertion techniques in patients without a history of previous abdominal surgery in a single center between January 2003 and June 2010. We assessed catheter survival at 3 and 12 months postinsertion and compared complication rates between the two groups. ♦ Results: A total of 63 percutaneous and 64 surgical catheter insertions were analyzed. No significant difference was noted in catheter survival rates between group P and group S (86.2% vs 80% at 3 months, p = 0.37; and 78.3% vs 71.2% at 12 months, p = 0.42 respectively). Early and overall peritonitis rates were similar (5% vs 5.3%; p = 1, and 3.5 vs 4.9 episodes per 100 patient-months; p = 0.13 for group P and group S respectively). There were also no significant differences between the two groups in exit site leaks (15.9% in group P vs 6.3% in group S; p = 0.15), poor initial drainage (9.5% in group P vs 10.9% in group S, p = 0.34) or secondary drainage failure (7.9% in group P vs 18.8% in group S, p = 0.09).

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

et al. 2015

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“…Although the differences in complication rates between the two techniques did not reach statistical significance, a trend toward greater leakage, malfunction, malposition, and bleeding was noted in the surgical group. Additional reports suggest equivalency of outcomes for the traditional surgical and percutaneous techniques (26,27). Only the newer (and less utilized) Placement of PD catheters by IR can often be obtained on an urgent basis in the late-referred chronic kidney disease patient.…”

Section: Discussionmentioning

confidence: 99%

Best Practices Consensus Protocol for Peritoneal Dialysis Catheter Placement by Interventional Radiologists

Abdelaal

Dybbro

Hathaway³

et al. 2014

Perit Dial Int

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Peritoneal dialysis (PD) catheters can be placed by interventional radiologists, an approach that might offer scheduling efficiencies, cost-effectiveness, and a minimally invasive procedure. In the United States, changes in the dialysis reimbursement structure by the Centers for Medicare and Medicaid Services are expected to result in the increased use of PD, a less costly dialysis modality that offers patients the opportunity to receive dialysis in the home setting and to have more independence for travel and work schedules, and that preserves vascular access for future dialysis options.

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“…Literature and courses can familiarize the operators with the appropriate techniques (13,14). Several studies suggest that catheters placed under radiologic guidance have technical outcomes comparable to those placed using an open or basic laparoscopic technique (15)(16)(17). Whether to place a catheter by the percutaneous approach or by the surgical approach should depend on local experience and the established mechanism for catheter placement at the individual site.…”

Section: Patient Selectionmentioning

confidence: 99%

Infrastructure Requirements for an Urgent-Start Peritoneal Dialysis Program

2013

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Patients with advanced chronic kidney disease nearing dialysis but without pre-established access almost uniformly initiate dialysis with a temporary central venous catheter. These catheters are associated with high rates of infection and flow disturbances, requiring removal and subsequent replacement. Many of these patients might be candidates for peritoneal dialysis (PD), but because of the absence of prior catheter placement, the default initial modality is hemodialysis. Recent reports, however, have demonstrated the feasibility of initiating PD urgently despite the late referral for access placement. Urgent-start PD clinical pathways require a unique infrastructure and treatment approach. This article reviews the salient features required to establish an urgent-start PD program.Perit Dial Int 2013; 33(6):611-617 www.PDIConnect.com

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A Comparative Analysis of Percutaneous and Open Surgical Techniques for Peritoneal Catheter Placement

Cited by 63 publications

References 33 publications

Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

Best Practices Consensus Protocol for Peritoneal Dialysis Catheter Placement by Interventional Radiologists

Infrastructure Requirements for an Urgent-Start Peritoneal Dialysis Program

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