Outcomes of fluoroscopic and ultrasound-guided placement versus laparoscopic placement of peritoneal dialysis catheters

Abstract

BackgroundSeveral peritoneal dialysis catheter (PDC) placement techniques have been described. The objective of this study was to compare the fluoroscopy and ultrasound guidance technique with the laparoscopic technique.MethodsWe retrospectively reviewed the medical records of 260 patients who had their first PDC placed between January 2005 and June 2016. We compared the outcomes of the fluoroscopic and ultrasound-guided catheter placement technique (radiologic group, n = 50) with the laparoscopic catheter placement technique (laparoscopic group, n = 190). The primary endpoint was complication-free catheter survival at 365 days. Secondary endpoints were complication-free catheter survival at 90 days, overall catheter survival at 90 and 365 days, median days to first complication and median days to catheter removal.ResultsIn the radiologic group, the complication-free catheter survival at 90 and 365 days was 64% and 48%, respectively, while in the laparoscopic group it was 71% (P = 0.374) and 53% (P = 0.494), respectively. Catheter malfunction was significantly higher in the laparoscopic group (30%) compared with the radiologic group (16%, P = 0.048). The overall catheter survival at 90 and 365 days was 76% and 52%, respectively, in the radiologic group, while in the laparoscopic group it was 88% (P = 0.0514) an 48% (P = 0.652), respectively. There was no significant difference in the median days to first complication and the median days to catheter removal between the two groups (P = 0.71).ConclusionThe technique of fluoroscopic and ultrasound-guided PDC placement is a clinically effective and safe alternative to laparoscopic catheter placement with similar survival and complication rates.

Ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar: A modified percutaneous PD catheter placement technique

“…In contrast, retrospective studies have reported incidences of 20.2% using blind percutaneous insertion and 27.1% using laparoscopy 20,21 . In some reports, incision and tunnel infection have occurred regardless of technique (surgical laparotomy, percutaneous puncture, or laparoscopic catheterization) 5,20,22 . We believe that our new PD catheterization method has inherent advantages in this regard.…”

Comparison of Outcomes between Percutaneous and Surgical Placement of Peritoneal Dialysis Catheters in Uremic Patients: A Meta-Analysis

“…Of the 20 studies, most (9 studies) [1, 4, 5, 19, 31-35] compared the blind percutaneous insertion technique with open surgery, 1 [36] compared percutaneous techniques utilizing radioscopic guidance or not with open surgery and reported respective outcomes. Three studies [37-39] compared the blind percutaneous method with laparoscopy, 1 study [40] compared the blind percutaneous technique with open surgery or laparoscopy, 1 study [41] compared the guided percutaneous method with open surgery, 4 studies [18, 20, 42, 43] compared the guided percutaneous method with laparoscopy, and 1 study [44] compared the guided percutaneous technique with open surgery or laparoscopy. Overall, the pooled data included 3,626 PD catheter insertions, with 1,826 percutaneous procedures and 1,800 surgical procedures.…”

Different techniques for peritoneal dialysis catheter implantation: A systematic review and network meta-analysis

“…Of the remaining 98 articles, 48 of them did not meet the inclusion criteria and were excluded after reading the full text. Finally, 41 eligible papers were included, 18 –58 namely, 9 RCTs 18 –26 and 32 observational clinical studies. 27 …”

“…Finally, 41 eligible papers were included, 18 –58 namely, 9 RCTs 18 –26 and 32 observational clinical studies. 27 …”

“…Sample size ranged from 26 to 357 patients. One-third of the enrolled RCTs 18,24,26 and 44% of the observational clinical studies 36,38,39,42 –48,53,54,57,58 had the sample size of more than 100 patients. In RCTs, the age of patients ranged from 47.9 years to 61 years, and 41% were male.…”