Assessment of complications and short-term outcomes of percutaneous peritoneal dialysis catheter insertion by conventional or modified Seldinger technique

Abstract

Objective: To explore the efficacy and short-term complications of a modified technique to percutaneously insert a peritoneal dialysis catheter. Methods: We reviewed the outcomes of 94 patients who underwent peritoneal dialysis catheterization between October 2017 and April 2020. Of these, 47 cases were placed by a conventional Seldinger technique, whereas 47 cases were placed by a modified technique based on the Seldinger method. The success rates of the catheter insertion and three-month postoperative complications were compared between these two groups. Results: The catheter insertion success rates were comparable between the two groups: 93.6% in the conventional technique group and 97.9% in the modified technique group (p ¼ 0.307). The incidence of postoperative catheter migration was lower using the modified technique (4.3%) than the conventional technique (18.3%) (p ¼ 0.037). None of the patients in the modified technique group had postoperative dialysate leakage, whereas this occurred in 9.0% of patients in the conventional technique group (p ¼ 0.036). There were no statistically significant differences in the incidence of postoperative bleeding, infection, or visceral damage between the two groups. Conclusions: The modified Seldinger technique for percutaneous peritoneal dialysis catheter insertion reduced the short-term postoperative complications of catheter migration and dialysate leakage, with a comparable successful catheter insertion rate compared with the conventional Seldinger technique.

Clinical Application of Peritoneal Dialysis Catheterization without Capsular Puncture Technique

“…A large number of experts at home and abroad have made continuous innovations in the methods of PD Catheterization, aiming for less trauma to patients, longer service life of catheters, less complications for patients, and lower cost of treatment. The technique has evolved from the initial open catheterization and laparoscopic catheterization to the more recent Seldinger technique and trocar technique [ 7 ].…”

Modified minimally invasive laparoscopic peritoneal dialysis catheter insertion with internal fixation

“…Neither intraoperative complications nor leakage occurred in any of the cases despite the early start on dialysis. Veress needle can also be used for skin puncture in replacement of the puncture needle in percutaneous PDC insertion by modified Seldinger technique [ 26 ]. Percutaneous technique is also a minimally invasive procedure that is widely used in placing PDCs.…”

“…Percutaneous PDC insertion often uses Seldinger technique under ultrasound guidance. The Seldinger technique has its inherent complications such as unsuccessful puncture, bleeding and visceral injury because of blind penetration, especially for patients who have previous abdominal surgeries that may cause intraperitoneal adhesions [ 26 ]. At this point, laparoscopic PDC insertion is superior to ultrasound guided percutaneous technique because of direct observation of the abdominal cavity and PDC.…”

Comparison of peripherally inserted central catheters (PICCs) versus totally implantable venous-access ports in pediatric oncology patients, a single center study

“…The Seldinger technique was used in both groups 22 . A detailed description of the methods of TIVAPs and PICCs can be found in the literature 9 , 21 .…”