7. ANALYSIS OF THE RESULTS OF LAPAROSCOPIC TUNNELLED PERITONEAL DIALYSIS CATHETER PLACEMENT

Abstract

Abstract Introduction Peritoneal dialysis is a type of renal replacement therapy that improves quality of life and empowers patients with advanced chronic kidney disease. The best method of peritoneal dialysis catheter (PDC) placement remains to be defined. Methods Retrospective observational study from October 2019 to March 2023, aiming to analyse the results of this new technique for PDC placement in our centre. Results The study consisted of 45 patients, 66.7% of whom were men. The study comprised 45 patients, with 66.7% being men. The mean age was 57 years, and the mean BMI was 27.9 kg/m2, with 82.8% of the patients classified as ASA III. In 66.7% of cases, it was the first catheter to be placed. Of the surgeries conducted, 41 involved initial placements, and 4 involved laparoscopic repositioning, the latter following a previously unsuccessful Alpha manoeuvre. In 6 cases, an associated surgery was performed. The mean duration of surgery was 34 minutes, with a median length of stay of 24 hours. In 3 patients, catheter malfunction occurred, with 2 requiring laparoscopic repositioning and the remaining one laparoscopic replacement. Additionally, 3 other patients experienced infectious complications, which were treated conservatively. No major complications or laparoscopy conversions were noted. The mean follow-up from surgery was 15.4 months, with 42.2% of PDCs being removed after a mean of 11.5 months, and renal transplantation being the most common reason for removal (79%). Conclusion In our centre, tunnelled PDC placement has proven to be safe and effective, with a low percentage of infections, relocations or replacements, and it is considered the technique of choice for patients capable of undergoing surgery under general anaesthesia.