Abstract

Objective: To assess laparoscopic peritoneal dialysis (PD) catheter placement techniques and complications among End Stage Renal Disease (ESRD) patients at Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia.

Methods: Retrospective review was performed on patients who underwent laparoscopic PD catheter placement with tunneling +/- adhesionlysis and omentopexy or omentectomy, between July 2008 and June 2018, by a single surgeon at Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia.

Results: Two hundred and twenty-two patients underwent laparoscopic PD catheter insertion during the study period. Late complications encountered include: tuberculosis (TB) peritonitis in 9 patients (4%), catheter dysfunction in 13 patients (6%), adhesions in 2 patients (1%), bacterial peritonitis in 25 patients (11%), leakage in 15 patients (7%), and 16 patients (7%) developed an umbilical hernia. There is a superficial fungal infection around the catheter exit in one patient (0.45%), and exit-site bacterial infection in 7 patients (3%). Catheter remained active for the first insertion in 33 patients (15%) and was reinserted in 7 patients (3%). Fifty-one patients (23%) underwent renal transplantation, and 82 (37%) patients were switched to hemodialysis. Eleven patients (5%) were lost to follow up, and 45 patients (20%) died due to their chronic illness. Seven (28%) of the 25 patients with bacterial peritonitis were cured with conservative management in the form of antibiotics and other conservative measures. There was no procedure-related mortality or bleeding.

Conclusion: Laparoscopic PD catheter insertion is safe and effective. Utilization of this technique provides a low rate of PD catheter complications. However, we encountered a noticeable rate of peritoneal tuberculosis in our patients.

Keywords: Peritoneal Dialysis Catheter; Laparoscopic Surgery; Complications of Peritoneal Catheter Insertion

References

1. Tenckhoff H and Schechter H. “A bacteriologically safe peritoneal access device”. Transactions - American Society for Artificial Internal Organs 14 (1968): 181-187.
2. Nghiem DD. “A technique of catheter insertion for uncomplicated peritoneal dialysis”. Surgery, Gynecology and Obstetrics 157 (1983): 573-576.
3. Brandt CP and Franceschi D. “Laparoscopic placement of peritoneal dialysis catheters in patients who have undergone prior abdominal operations”. Journal of the American College of Surgeons 178 (1994): 515-516.
4. Watson DI., et al. “Secure placement of peritoneal dialysis catheters using a laparoscopic technique”. Surgical Laparoscopy Endoscopy 6 (1996): 35-37.
5. Nijhu is PH., et al. “Laparoscopic introduction of a continuous peritoneal dialysis (capd) catheter by a two-puncture technique”. Surgical Endoscopy 10 (1996): 676 -679.
6. Crabtree JH and Fishma nA. “Yideolaparoscopic implantation of peritoneal dialysis catheters”. Surgical Endoscopy 13 (1999): 186-190.
7. Barone GW., et al. “Technique for laparoscopy-assisted complicated peritoneal dialysis catheter placement”. Journal of Laparoendoscopic and Advanced Surgical Techniques 12 (2002): 53-55.
8. Stephe H., et al. “Guidelines for laparoscopic dialysis access surgery”. Surgical Endoscopy 28 (2014): 3016-3045.
9. Lu CT., et al. “Laparoscopic placement of peritoneal dialysis catheters: 7 years experience”. ANZ Journal of Surgery 73 (2003): 109-111.
10. Manouras AJ., et al. “Laparoscopic placement of Oreopoulos­ Zellerman catheters in CAPD patients”. Peril Dial J 24 (2004): 252-255.
11. Crabtree JH and Fishman A. “A laparoscopic method for optimal peritoneal dialysis access”. American Surgery 71 (2005): 135-143.
12. Harissis HV., et al. “A new simplified one port laparoscopic technique of peritoneal dialysis catheter placement with intra-abdominal fixation”. American Journal of Surgery 192 (2006): 125-129.
13. Saudi Center for Organ Transplantation. Scot data”. Saudi Journal of Kidney Disease and Transplantation 8 (1997): 320-328.
14. Ellam T and Wilkie M. “Peritoneal dialysis”. Medicine 35 (2007): 466-469.
15. Olcott C., et al. “Continuous ambulatory peritoneal dialysis. Technique of catheter insertion and management of associated surgical complications”. American Journal of Surgery 146 (1983): 98-102.
16. Strippoli GF., et al. “Catheter type, placement and insertion techniques for preventing peritonitis in peritoneal dialysis patients”. Cochrane Database System Review (2004): CD004680.
17. Bullmaster JR., et al. “Surgical aspects of the Tenckhoff peritoneal dialysis catheter. A 7-year experience”. American Journal of Surgery 149 (1985): 339-342.
18. Lui SL., et al. “Tuberculosis infection in Chinese patients undergoing continuous ambulatory peritoneal dialysis”. American Journal of Kidney Diseases 38 (2001): 1055-1060.
19. Lui SL., et al. “Optimal treatment and long-term outcome of tuberculous peritonitis complicating continuous ambulatory peritoneal dialysis”. American Journal of Kidney Diseases 28 (1996): 747-751.
20. Pesanti EL. “Immunologic defects and vaccination in patients with chronic renal failure”. Infectious Disease Clinics of North America 15 (2001): 813-832.

Citation

Citation: Saud Faleh Alomani., et al. “Laparoscopic Peritoneal Dialysis Catheter Insertion”.Acta Scientific Women's Health 2.2 (2020): 54-57.

Copyright

Copyright: © 2020 Saud Faleh Alomani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.