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https://hdl.handle.net/2440/10508
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Type: | Journal article |
Title: | Laparoscopic placement of peritoneal dialysis catheters: 7 years experience |
Author: | Lu, C. Watson, D. Elias, T. Faull, R. Clarkson, A. Bannister, K. |
Citation: | ANZ Journal of Surgery, 2003; 73(3):109-111 |
Publisher: | Blackwell Science Asia |
Issue Date: | 2003 |
ISSN: | 1445-1433 1445-2197 |
Statement of Responsibility: | Cu T. Lu, David I. Watson, Tony J. Elias, Randall J. Faull, Anthony R. Clarkson and Kym M. Bannister |
Abstract: | <h4>Background</h4>Since 1994 we have placed all peritoneal dialysis (Tenckhoff) catheters at our hospital laparoscopically using a technique that incorporates suture fixation into the pelvis. The purpose of this study was to determine the long-term outcome of this approach.<h4>Method</h4>Perioperative and follow-up data for all patients undergoing placement of a peritoneal dialysis catheter at the Royal Adelaide Hospital were collected prospectively and managed on unit specific and hospital wide computerized databases. A total of 148 procedures were carried out in 123 patients from March 1994 to November 2001. Follow-up ranged from 3 to 68 months (median, 42 months). All procedures were undertaken or supervised by one surgeon, and catheters were routinely sutured into the pelvis at laparoscopy.<h4>Results</h4>There was no perioperative mortality in this series, and only one catheter could not be placed laparoscopically. This was in a patient with extensive intra-abdominal adhesions. Mean operative time was 27 min (range, 10-100 min), and mean postoperative stay was 2.8 days (range, 1-12 days). Seven (5%) patients experienced peri/postoperative haemorrhage, and four of these underwent surgical re-exploration. Twenty-five (17%) catheters are still used for dialysis. Thirty-four (23%) catheters were removed when the recipient received a subsequent renal transplant, and 42 (28%) patients died during follow-up. Forty-six (31%) patients required catheter revision or removal because of technical problems; 26 (18%) recurrent peritonitis or exit site infection; and 20 (14%) catheter blockage. Twenty-eight reinsertion procedures were carried out in 25 patients. Ten (7%) patients developed port site hernias at late follow-up, and required hernioplasty. Catheter migration leading to malfunction (poor drainage) occurred in eight (5%) patients only.<h4>Conclusions</h4>Laparoscopic placement of peritoneal dialysis catheters is a safe and effective procedure. The majority of patients will dialyse successfully using this technique. Suturing the catheter tip into the pelvis is associated with a low rate of catheter migration. |
Keywords: | Pelvis Uterus Humans Kidney Failure, Chronic Postoperative Complications Laparoscopy Peritoneal Dialysis, Continuous Ambulatory Suture Techniques Follow-Up Studies Catheters, Indwelling Time Factors Adult Aged Aged, 80 and over Middle Aged Female Male Urinary Bladder Outcome Assessment, Health Care |
Description: | Journal compilation © 2009 Royal Australasian College of Surgeons |
Provenance: | Published Online: 14 Mar 2003 |
DOI: | 10.1046/j.1445-2197.2003.02651.x |
Published version: | http://dx.doi.org/10.1046/j.1445-2197.2003.02651.x |
Appears in Collections: | Aurora harvest 7 Surgery publications |
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