A nephrologist dream of peritoneal dialysis catheter with zero migration: A multicenter prospective study

Al‐Hwiesh, Abdullah K.; Abdul‐Rahman, Ibrahiem Saeed; Divino‐Filho, Jose Carolino; Nasreldin, Mohamed A.; Al‐Hwiesh, Amani A.; Al‐Audah, Nadia; Althubaini, Hatem H.; Abdulgalil, Moaz; Salah, Ghassan A.; Al‐Baggal, Mohammad Z.; Abu‐Oun, Bassam A.; Al‐Audah, Nehad; Al‐Ramadan, Habib S.; Alfalah, Kaltham; Almarri, Zahra; Al‐Awal, Ayat A.

doi:10.1111/1744-9987.14045

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…However, the three-cuff PDC is more complex to operate compared to conventional catheters, there is no routine clinical application currently. In addition, the three-cuff PDC and the right size dilator are difficult to obtain in many hospitals [ 26 ]. In our method, the use of a suture passer aimed to reduce additional trocar drilling, minimizing damage to the abdominal wall.…”

Section: Discussionmentioning

confidence: 99%

Suture passer combined with two-hole laparoscopic peritoneal dialysis catheterization in patients undergoing peritoneal dialysis

Zhu,

Xin,

Man

et al. 2024

Renal Failure

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Background Laparoscopic techniques are being widely applied for peritoneal dialysis (PD) catheter (PDC) placement. The suture passer is a novel fixation tool that aims to reduce catheter migration. We compared the clinical value of the suture passer combined with two-hole laparoscopic PDC placement to open surgical placement by evaluating preoperative and postoperative conditions, as well as the onset of complications in both groups. Methods A retrospective study was conducted including 169 patients who underwent PDC placement surgery from January 2021 to May 2023. Based on the method employed, patients were divided into two groups: the suture passer combined with a two-hole laparoscopy group (SLG) and the open surgical group (SG). Comprehensive patient information, including general data, preoperative and postoperative indicators, peritoneal function after surgery, and the incidence rate of complications, were collected and analyzed. Results The SLG showed a statistically significant decrease in operative time, intraoperative blood loss, and 6-month postoperative drift rate compared to the SG ( p < 0.05). No statistically significant differences were observed between the two groups in terms of sex, age, primary disease, hospitalization time, hospitalization costs, preoperative and postoperative examination indicators, peritonitis, and omental wrapping. Conclusions Suture passer combined with two-hole laparoscopic PDC placement, characterized by simplicity and facilitating secure catheter fixation, was deemed safe and effective for patients undergoing PD. It reduces the catheter migration rate and improved surgical comfort. Overall, this technique demonstrates favorable outcomes in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Suture passer combined with two-hole laparoscopic peritoneal dialysis catheterization in patients undergoing peritoneal dialysis

Zhu,

Xin,

Man

et al. 2024

Renal Failure

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“…A logical concern is the compromise of lung capacities and volumes secondary to fluid infusion into the abdominal cavity; however, there is evidence showing that the effect on lung function is minimal [19]. Similarly, survival in critically ill patients is equivalent to other RRT techniques [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Dialysis during the COVID-19 Pandemic Is an Effective Treatment in Developing Countries: A Report from Mexico

Villa-Torres,

Vásquez-Jiménez,

Velazquez-Silva

et al. 2023

Blood Purif

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Introduction: During the height of the coronavirus disease-19 (COVID-19) pandemic, some renal replacement therapy (RRT) modalities were insufficient, forcing medical centers to diversify the RRT modalities offered. In this study, we reported the outcomes of chronic peritoneal dialysis (PD) patients and acute PD in critically ill patients during COVID-19 pandemic in a tertiary care medical center in Mexico. Methods: This descriptive, longitudinal, observational, retrospective study included 47 adult patients with atypical pneumonia in a tertiary care medical center in Mexico during the first and second waves of the COVID-19 pandemic. Chronic PD patients and PD incident patients due to acute kidney injury (AKI) were included. Results: Forty-seven patients were studied (29 chronic PD patients and 18 incident PD patients due to AKI); median age was 59 (48–68) years; 63.8% were men. The ultrafiltrate volume per day was 815 (596.1–1,193.2) mL. Overall mortality was 61.7%, 55.2% in chronic PD patients, and 72.2% in PD incident patients due to AKI. A higher Sequential Organ Failure Assessment (SOFA) score, the need for mechanical ventilation at admission, and the requirement for vasopressors were predictors for mortality (p < 0.01). Conclusion: In low- and lower-middle-income countries, PD was a valid alternative for RRT during the COVID-19 pandemic. In AKI patients, PD can correct hyperkalemia, acidosis, uremia, and volume overload; however, there was higher mortality in PD incident patients due to AKI. The main risk factors for mortality were a high SOFA score at admission, the need for invasive mechanical ventilation, and the requirement for vasopressors.

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“…Laparoscopic procedures allow direct visualization of the peritoneal space and detection of adhesions. [5][6][7] Adhesiolysis is recommended if the surgeon determines that the adhesions are likely to impede catheter placement or hinder its proper function. 8,9 Previous research has shown that the risk of adhesions averaged 54% among individuals with prior abdominal surgery, but it varied considerably by the type of surgery.…”

Section: Introductionmentioning

confidence: 99%

The Association of Intra-Abdominal Adhesions with Peritoneal Dialysis Catheter-Related Complications

Qureshi,

Maierean,

Crabtree

et al. 2024

CJASN

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Background: This study investigated the association of intra-abdominal adhesions with the risk of peritoneal dialysis (PD) catheter complications. Methods: Individuals undergoing laparoscopic PD catheter insertion were prospectively enrolled from eight centers in Canada and the United States. Patients were grouped based on the presence of adhesions observed during catheter insertion. The primary outcome was the composite of PD never starting, termination of PD, or the need for an invasive procedure caused by flow restriction or abdominal pain. Results: 758 individuals were enrolled, of whom 201 (27%) had adhesions during laparoscopic PD catheter insertion. The risk of the primary outcome occurred in 35 (17%) in the adhesion group compared to 58 (10%) in the no adhesion group (adjusted HR, 1.64; 95% CI; 1.05, 2.55) within six months of insertion. Lower abdominal or pelvic adhesions had an adjusted HR of 1.80 (95% CI; 1.09, 2.98) compared to the no adhesion group. Invasive procedures were required in 26 (13%) and 47 (8%) of the adhesion and no adhesion groups, respectively (unadjusted HR, 1.60: 95% CI; 1.04, 2.47) within six months of insertion. The adjusted odds ratio for adhesions for women was 1.65 (95% CI; 1.12, 2.41), for body mass index per 5 kg/m2 was 1.16 (95% CI; 1.003, 1.34) and for prior abdominal surgery was 8.34 (95% CI; 5.5, 12.34). Common abnormalities found during invasive procedures included PD catheter tip migration, occlusion of the lumen with fibrin, omental wrapping, adherence to the bowel and the development of new adhesions. Conclusions: People with intra-abdominal adhesions undergoing PD catheter insertion were at higher risk for abdominal pain or flow restriction preventing PD from starting, PD termination or requiring an invasive procedure. However, the majority of patients, with or without adhesions, did not experience complications, and most complications did not lead to the termination of PD therapy.

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A nephrologist dream of peritoneal dialysis catheter with zero migration: A multicenter prospective study

Cited by 4 publications

References 35 publications

Suture passer combined with two-hole laparoscopic peritoneal dialysis catheterization in patients undergoing peritoneal dialysis

Suture passer combined with two-hole laparoscopic peritoneal dialysis catheterization in patients undergoing peritoneal dialysis

Peritoneal Dialysis during the COVID-19 Pandemic Is an Effective Treatment in Developing Countries: A Report from Mexico

The Association of Intra-Abdominal Adhesions with Peritoneal Dialysis Catheter-Related Complications

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