Laparoscopic-assisted peritoneal dialysis catheter placement: a microinvasive technique |
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Authors: | Sergio A Carrillo Marcelo M Ghersi Stephen Wise Unger |
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Institution: | (1) Department of Surgery, University of Louisville, Louisville, KY 40202, USA;(2) Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL, USA |
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Abstract: | Background Peritoneal dialysis is an alternate form of dialysis for patients with end-stage renal disease (ESRD). Although not as widely
used as hemodialysis, peritoneal dialysis (PD) has clear advantages, especially those related to patient satisfaction and
simplicity. The purpose of our study was to describe and look at the results of a microinvasive technique for placement of
peritoneal dialysis catheters under laparoscopy.
Methods From August 2003 to January 2006, 12 patients with ESRD underwent laparoscopic-assisted peritoneal dialysis (LAPD) catheter
placement with the microinvasive technique at our institution. Data collected included age, gender, underlying renal disease,
and length of operation. Followup was completed for all patients (at least 6 months) and catheter-related morbidity and mortality
were also analyzed.
Results There were 13 procedures performed (one patient had LAPD catheter placement twice). The average age was 45 years and the most
common cause of ESRD was uncontrolled arterial hypertension. Procedural time averaged 33.6 min (range = 24–50 min). Peritoneal
dialysis was introduced two weeks after the procedure and no dialysate leaks were observed. There were two catheter-related
morbidities; both were catheter exit-site abscesses, one managed surgically with removal of the PD catheter and the other
managed conservately with culture-sensitive antimicrobials. Patient satisfaction was beyond acceptable in 92% of the patients
(12 of 13). Average longevity of the catheter was 61 weeks (427 days). There were no mortalities.
Conclusion LAPD catheter placement is an easy technique with acceptable catheter longevity and minimal morbidity. The microinvasive technique
leads to better patient satisfaction and cosmetic outcome without affecting its function. Therefore, we believe that by promoting
microinvasive LAPD catheter placement, PD will gain more acceptance among doctors and patients. |
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Keywords: | Laparoscopy Peritoneal dialysis Micro-invasive Peritoneal dialysis catheter |
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