J Korean Surg Soc.  2010 Feb;78(2):71-76. 10.4174/jkss.2010.78.2.71.

The Effect of an Anti-adhesion Agent in Continuous Ambulatory Peritoneal Dialysis (CAPD) Catheter Insertion Operation

• Kim KH
• Roh YH
• Kim YH
• Jung GJ
• An WS
• Kim SE
• Kim KH

• KMID: 2096557
• DOI: http://doi.org/10.4174/jkss.2010.78.2.71

Abstract

PURPOSE
Continuous ambulatory peritoneal dialysis (CAPD) is an important method of performing renal replacement therapy in patients with chronic renal failure. A significant complication of CAPD is malfunction of the catheter because of catheter adhesion that leads to catheter malposition. So we evaluated the effect of an anti-adhesive agent called Guardix-Sol(R).
METHODS
We prospectively evaluated the clinical results of 78 patients who had received CAPD catheter insertion from Sep. 2007 to May 2009. A test group of 34 patients used the anti-adhesion agent and a control group of 44 patients did not use it. All the procedures were standardized and performed by a single surgeon.
RESULTS
The patients consisted of 49 males and 29 females. The common reasons for CAPD insertion were diabetic nephropathy (47 patients) and hypertension (20 patients). Fifteen patients needed reposition operations during their postoperative course, which were done under spinal anesthesia. Out of 15 patients, 3 were from the test group (Guardix-Sol(R) group) and 12 from the control group (P=0.0526). All the repositioned patients had a malpositioned catheter because the greater omentum had adhered to the catheter, except for one patient in each group (P=0.0315).
CONCLUSION
Using an anti-adhesive agent for CAPD insertion is an effective method to reduce the incidence of greater omental adhesion. So the rate of reoperation cases for catheter repositioning is decreased.

Keyword

Continuous ambulatory peritoneal dialysis (CAPD); Anti-adhesive agent; Malposition

MeSH Terms

Anesthesia, Spinal
Catheters
Diabetic Nephropathies
Female
Humans
Hypertension
Incidence
Kidney Failure, Chronic
Male
Omentum
Peritoneal Dialysis, Continuous Ambulatory
Prospective Studies
Renal Replacement Therapy
Reoperation

Figure

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  Fig. 1 The Guardix-sol Application. The continuous ambulatory peritoneal dialysis catheter.

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  Fig. 2 (A) The continuous ambulatory peritoneal dialysis catheter tip is located in the Douglas pouch. (B) The fluoroscopic view shows a properly placed continuous ambulatory peritoneal dialysis catheter in pelvic cavity.

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  Fig. 3 The simple abdomen X-ray shows a continuous ambulatory peritoneal dialysis catheter malposition.

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