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J Korean Soc Endosc Laparosc Surg. 2011 Dec;14(2):106-110. Korean. Original Article.
Hong SK , Kim SH , Ha IS , Jung SE , Park KW , Kim HY .
Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea. spkhy02@snu.ac.kr
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
Abstract

PURPOSE: Laparoscopic continuous ambulatory peritoneal dialysis (CAPD) catheter insertion is used instead of open CAPD insertion because additional measures to prevent complications can be made without a conventional laparotomy. This study compared the early experience of laparoscopic CAPD catheter insertion with open CAPD insertion in children. METHODS: Between January 2006 and May 2011, 52, 16 and 36 patients who underwent CAPD insertion, laparoscopic CAPD insertion and open CAPD insertion, respectively, for end stage renal disease at Seoul National University Children's Hospital were enrolled in this study. The clinicopathological factors, operative factors and outcomes were analyzed by a retrospective medical record review. RESULTS: The mean operative time of the laparoscopic group was longer than that of the open groups (78 minutes vs 60 minutesm, p value=0.079). In the laparoscopic group, 3 patients underwent closure of the processus vaginalis and the occurrence of an inguinal hernia was prevented, whereas 3 patients in the open group underwent herniorrhaphy for an inguinal hernia. The mean period of catheter use in the laparoscopic and open group was 201 and 984 days, respectively. Complications occurred more frequently in the open group than in the laparoscopic group (14 patients (38.9%) vs. 2 patients (12.5%), p value=0.059). Peritonitis (19.4%) was the most common complication, which occurred only in the open group, followed by catheter obstruction due to omental wrapping. Catheter migration occurred more frequently in the open group (20%) than the laparoscopic group (12.5%). CONCLUSION: These results suggest that laparoscopic CAPD catheter insertion can be a suitable method for CAPD catheter insertion in children.

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