A half-percutaneous technique for peritoneal dialysis catheter implantation using a modified trocar: a report of 84 cases.

Abstract

Peritoneal dialysis (PD) catheter implantation is necessary for patients with end-stage renal disease (ESRD) to maintain continuous ambulatory PD (CAPD). In this study, we aimed to introduce a half-percutaneous technique based on a modified trocar device for the placement of a PD catheter and to evaluate the safety and efficacy of this technique and its associated short-term postoperative outcomes. Eighty-four ESRD patients who underwent PD catheter implantation with the half-percutaneous technique were recruited retrospectively between September 2016 and October 2017 from the Guangdong Provincial Hospital of Chinese Medicine. All catheter implantation procedures were performed by the same three nephrologists. The surgical protocol was described in detail, and the general intraoperative parameters and short-term complications were evaluated. All ESRD patients underwent successful PD catheterization with our novel technique. Neither conversion from this method to traditional open surgery nor major intraoperative complications were observed. The mean operative time was 20.8 ± 4.5min, and the incision length was 2.28 ± 0.53cm. The operative cost was CN ¥ 1762.45 (US $261), and the length of hospital stay was 7.5 ± 0.58days. One patient (1.19%) showed leakage, and one patient (1.19%) experienced bleeding 2 weeks after the surgery. Catheter dysfunction due to catheter tip migration occurred in nine patients (10.7%) 2 weeks after the procedure, and the placement of the catheter was corrected with conservative treatment. No visceral injuries or PD-related infections were observed up to 4 weeks after the catheters were implanted. This half-percutaneous technique for PD catheter implantation appears to be a safe, effective and feasible procedure. This technique has the advantages of reduced surgical trauma, a shorter operative time and faster postsurgical recovery. In particular, this novel technique is easy for nephrologists to perform and therefore may help to promote and popularize PD treatment.