Simplified Percutaneous Placement of Peritoneal Dialysis Catheters: Comparison with Surgical Placement

Roueff, S.; Pagniez, Dominique; Moranne, Olivier; Roumilhac, Didier; Talaszka, A; Sagazan, H Le Monies de; Dequiedt, P; Boulanger, Éric

doi:10.1177/089686080202200216

Cited by 30 publications

(41 citation statements)

References 6 publications

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“…These results indicate that a well-planned and implemented technique may avoid the need for direct or The total incidence of peritonitis episodes was one every 29.5 months (0.44 episodes/patient-year) and no significant difference was verified regarding this complication among the groups. These results were very similar to those reported in the literature for percutaneous and surgical catheter placements (22,(26)(27)(28)31,32,34). On the other hand, there are few publications on image-guided procedures, with some reports describing an incidence of one episode of peritonitis every 14.5-21.1 months (33)(34)(35).…”

Section: Discussionsupporting

confidence: 87%

“…The most common noninfectious complication in the present study was CD. The incidence of this complication according to some reports varies between 3.2 and 34.7%, in percutaneous insertions, which did not use image guidance (21)(22)(23)(24)(25), whereas in surgical insertions, CD has been verified to take place from 3.2 to 20% of the procedures according to the report (26)(27)(28)(29)(30)(31). On the other hand, a CD rate of 20% (32)(33)(34)(35) has been observed in PD catheters, which were placed by radioscopy guidance.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous and Surgical Insertion of Peritoneal Catheter in Patients Starting in Chronic Dialysis Therapy: A Comparative Study

Chula

Campos²,

Alcântara³

et al. 2013

Seminars in Dialysis

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Percutaneous peritoneal catheter insertion can be performed by trained nephrologists. The objective of this study was to compare the outcome of peritoneal dialysis (PD) catheters percutaneous inserted with the traditional surgical technique. One hundred twenty-one PD catheters were placed in 121 stage-5 Chronic kidney disease patients using three techniques: percutaneous insertion (Group P, n = 53), percutaneous insertion guided by radioscopy (Group R, n = 26), and surgical insertion (Group S, n = 42). The mean age of the whole cohort was 57 ± 16 years and 54% were male. Patients and catheter outcomes were followed up prospectively for 19 months. Gender, age, body mass index, previous abdominal surgeries, and the prevalence of diabetes mellitus were not significantly different among the groups as well as the incidence of bleeding and the presence of catheter dysfunction. In addition, the incidence of exit-site infections and peritonitis was not significantly different among the groups. Finally, the survival catheter rate was not significantly different by the end of the follow-up of 19 months (70% in P group, 85% in R, and 70% in S group (log rank = 0.88, p = 0.95). The outcome of percutaneous implanted catheters, which were inserted by a trained nephrologist, did not demonstrate to be inferior as compared with the traditional surgical approach.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Percutaneous and Surgical Insertion of Peritoneal Catheter in Patients Starting in Chronic Dialysis Therapy: A Comparative Study

Chula

Campos²,

Alcântara³

et al. 2013

Seminars in Dialysis

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“…The main purpose of our study was to compare the 1- year catheter survival rate between the percutaneous group and surgery group. Six observational studies [21] , [23] , [24] , [25] , [26] , [27] including 1199 procedures reported 1-year catheter survival as an outcome. The rate of 1-year catheter survival in the percutaneous group and surgery group were 80.2% (455/566) and 73.0% (462/633), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, the pooled data of the sensitivity analysis from 7 observational studies [21] , [24] , [25] , [26] , [27] , [29] , [30] showed no significant difference in the incidence of overall mechanical complications in either catheter placement techniques [31.8% and 36.9% (percutaneous vs. surgery)] (OR = 0.81, 95% CI = 0.46–1.43, P = 0.46). Significant heterogeneity between the studies was found (P < 0.0001, I 2 = 80%).…”

Section: Resultsmentioning

confidence: 99%

“…Sixes studies [21] , [22] , [25] , [27] , [29] , [30] reported the rate of peritonitis as 25.9% (110/424) and 23.1% (132/572) in the percutaneous and surgery groups respectively. The pooled analysis of the odds ratio indicated no significant difference in the peritonitis rate (OR = 0.93, 95% CI = 0.54–1.60, P = 0.79) between both techniques.…”

Section: Resultsmentioning

confidence: 99%

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Surgical versus percutaneous techniques for peritoneal dialysis catheter placement: A meta-analysis of the outcomes

Tullavardhana

Akranurakkul

Ungkitphaiboon

et al. 2016

Annals of Medicine &Amp; Surgery

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BackgroundPeritoneal dialysis (PD) is an effective method of renal replacement therapy for end-stage renal disease patients. The PD catheter could be inserted by surgical (open surgery/laparoscopic-assisted) or percutaneous techniques. However, the efficacy of the techniques, including catheter survival and catheter related complications, is still controversial.MethodThe dataset was defined by searching PubMed, EMBASE, Google Scholar and the Cochrane database that had been published until July 2014. The meta-analysis was performed using Review Manager Software version 5.2.6.ResultThe final analysis was conducted on 10 studies (2 randomized controlled studies (RCTs) and 8 retrospective studies), including 1626 patients. The pooled data demonstrate no significant difference in 1-year catheter survival (OR = 1.04, 95% CI = 0.52–2.10, P = 0.90) between surgical and percutaneous groups. However, the sensitivity analysis of the RCTs demonstrated that the incidence of overall infectious (OR = 0.26, 95% CI = 0.11–0.64, P = 0.003) and overall mechanical complications (OR = 0.32, 95% CI = 0.15–0.68, P = 0.003) were significantly lower in the percutaneous groups than the surgical groups. Furthermore, the subgroup analyses revealed no significant difference in the rates of peritonitis, tunnel and exit site infection, leakage, inflow-outflow obstruction, bleeding and hernia by comparing the methods.ConclusionThe results showed that the placement modality did not affect 1-year catheter survival. Percutaneous catheter placement is as safe and effective as surgical technique.

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Different outcomes of peritoneal catheter percutaneous placement by nephrologists using a trocar versus the Seldinger technique: the experience of two Brazilian centers

et al. 2014

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A good catheter implantation technique is important to allow effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with different techniques have been limited. The aim of this study was to investigate the rate of early catheter-related complications and catheter survival in two Brazilian centers, according to two different percutaneous methods of catheter implantation performed by nephrologist team. Adult incident patients recruited from January 2006 to July 2013 having undergone first peritoneal dialysis (PD) catheter implantation were included in the analysis. Mechanical and infectious early complication rates were defined as time to the first event occurring up to 3 months. Four hundred and forty-five consecutive Tenckhoff catheters were implanted by nephrologist team percutaneously after antibiotic prophylaxis in an operating room: trocar was used in 349 (78.4 %) and Seldinger technique (ST) in 99 (21.6 %). The ST was significantly associated with a lower rate of leak (16.3 vs 3 %, p = 0.03) and outflow failure due to tip catheter migration (22.6 vs 10.1 %, p = 0.04), while early infectious complication rates were similar between the two groups (p = 0.59). Long-term catheter survival was higher in Seldinger group (log-rank, p = 0.031). By Cox multivariate analysis, adjusted for age, sex, and diabetes, the ST remained independently associated with better catheter survival [HR 0.681 (0.462-0.910), p = 0.04]. As conclusion, our experience showed better PD outcomes with the ST than trocar method of catheter implantation by nephrologist.

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Simplified Percutaneous Placement of Peritoneal Dialysis Catheters: Comparison with Surgical Placement

Cited by 30 publications

References 6 publications

Percutaneous and Surgical Insertion of Peritoneal Catheter in Patients Starting in Chronic Dialysis Therapy: A Comparative Study

Percutaneous and Surgical Insertion of Peritoneal Catheter in Patients Starting in Chronic Dialysis Therapy: A Comparative Study

Surgical versus percutaneous techniques for peritoneal dialysis catheter placement: A meta-analysis of the outcomes

Different outcomes of peritoneal catheter percutaneous placement by nephrologists using a trocar versus the Seldinger technique: the experience of two Brazilian centers

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