J Korean Surg Soc.  2002 Feb;62(2):133-138.

Experience of Catheter Implantation for Continuous Ambulatory Peritoneal Dialysis and Catheter Related Complications

• Kwak JM
• Jung SI
• Min YK
• Kang SH
• Joh YG
• Cho MY
• Song TJ
• Lee JB
• Bae JW
• Suh SO
• Kim YC
• Whang CW
• Cho WY
• Kim HK

Abstract

PURPOSE: By virtue of advances in scientific methods and technical systems, there has been a rapid growth in the number of end stage renal disease (ESRD) patients treated using continuous ambulatory peritoneal dialysis (CAPD) as their primary renal replacement therapy. However, there are various catheter related complications that are limiting factors in patient and catheter maintenance. This study was aimed at introducing of the techniques of CAPD catheter implantation designed for reducing the complication rate, as well as conducting an investigation of the incidence of CAPD catheter related complications and patient survival and catheter survival rates.
METHODS
We performed 234 cases of CAPD catheter implantation using a conventional surgical method (n=162, between January 1993 and December 1997) or a modified surgical method (n=72, between January 1998 and December 1999), and retrospectively reviewed the patient's medical records to elucidate the incidence of early catheter related complications and the catheter removal rate in relation to the surgical methods.
RESULTS
There were 21 cases (23.8%) of peritonitis in the modified group, which was less than that in the conventional group (79 cases, 48.8%) (P=0.036). There were 9 cases (12.5%) of exit site and tunnel infection in the modified group, which was less than that in the conventional group (36 cases, 22.2%) (P=0.019). We were able to reduce the peritonitis as well as exit site and tunnel infection by a long segment of tunneling and immobilization of the catheter to the skin. Nine cases of leakage (5.5%) have occurred in the conventional group and one case (1.3%) in the modified group; the difference was statistically significant (P=0.046).
CONCLUSION
These results indicate that our modified surgical methods can reduce the rate of early catheter related complications.

Keyword

Continuous ambulatory peritoneal dialysis; End stage renal disease; Catheter related complication

MeSH Terms

Catheters*
Humans
Immobilization
Incidence
Kidney Failure, Chronic
Medical Records
Peritoneal Dialysis, Continuous Ambulatory*
Peritonitis
Renal Replacement Therapy
Retrospective Studies
Skin
Survival Rate
Virtues