Abstract
BackgroundMost end-stage renal disease (ESRD) patients undergo open surgical techniques for peritoneal dialysis (PD) catheter placement. An alternative method to PD catheter implantation is the half-percutaneous (“Half-Perc”) technique based on a modified trocar that is performed by a nephrologist. The single-center, retrospective, observational, cohort study presented here aimed to compare the effects of the “Half-Perc” technique with the traditional open surgery on peritoneal catheter insertion.MethodsFrom January 2015 to January 2018, 240 ESRD patients who received initial PD catheter placement were divided into two groups based on the “Half-Perc” technique or open surgery. All patients were followed up for 365 days or until loss of initial PD catheter or death. Prism 5 software was used to analyze baseline characteristics, operation-related parameters, mechanical complications and clinical outcomes.ResultsThe “Half-Perc” technique showed shorter operation time, shorter incision length, lower postoperative pain scores and quick initiation of the PD program compared to the open surgery. After the 365-day follow-up, the “Half-Perc” group showed a higher rate of catheter dysfunction (4% versus 0.9%) that was corrected by conservative treatment in most patients and a lower rate of peritonitis (4% versus 9.6%) but mechanical complications and clinical outcomes did not differ between the two groups. There was also no significant difference based on overall patient mortality or catheter removal. One-year initial catheter survival and true catheter survival were not statistically different between the groups.ConclusionThe “Half-Perc” placement of the PD catheter using a modified metal trocar appears to be a non-inferior alternative method and carries minimal invasiveness and risk compared to open surgical placement.
Highlights
Most end-stage renal disease (ESRD) patients undergo open surgical techniques for peritoneal dialysis (PD) catheter placement
A half-percutaneous (“Half-Perc”) technique based on a modified metal trocar in China is an alternative method of PD catheter implantation performed by nephrologists [10]
The “Half-Perc” group showed a higher number of males and showed higher average Body mass index (BMI)
Summary
Most end-stage renal disease (ESRD) patients undergo open surgical techniques for peritoneal dialysis (PD) catheter placement. An alternative method to PD catheter implantation is the half-percutaneous (“Half-Perc”) technique based on a modified trocar that is performed by a nephrologist. A half-percutaneous (“Half-Perc”) technique based on a modified metal trocar in China is an alternative method of PD catheter implantation performed by nephrologists [10]. This novel technique was first introduced by Zhu Bai et al in 2002 [11, 12] and shares some of the advantages of the percutaneous approach for PD catheter placement [13], including shorter operation duration and generally minimal tissue trauma, which results in less pain and a quick recovery [14]
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