Abstract
BackgroundPeritoneal dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemodialysis. Key to successful PD is the presence of a well-functioning dialysis catheter. Several complications, such as in- and outflow obstruction, peritonitis, exit-site infections, leakage and migration, can lead to catheter removal and loss of peritoneal access. Currently, different surgical techniques are in practice for PD-catheter placement. The type of insertion technique used may greatly influence the occurrence of complications. In the literature, up to 35% catheter failure has been described when using the open technique and only 13% for the laparoscopic technique. However, a well-designed randomized controlled trial is lacking.Methods/DesignThe LOCI-trial is a multi-center randomized controlled, single-blind trial (pilot). The study compares the laparoscopic with the open technique for PD catheter insertion. The primary objective is to determine the optimum placement technique in order to minimize the incidence of catheter malfunction at 6 weeks postoperatively. Secondary objectives are to determine the best approach to optimize catheter function and to study the quality of life at 6 months postoperatively comparing the two operative techniques.DiscussionThis study will generate evidence on any benefits of laparoscopic versus open PD catheter insertion.Trial registrationDutch Trial Register NTR2878
Highlights
Peritoneal dialysis (PD) is an effective treatment for end-stage renal disease
Approximately 15.000 patients in the Netherlands are diagnosed with end-stage renal disease (ESRD) and are dependent on renal replacement therapy
In the literature, case-series suggest that the laparoscopic insertion technique is to be preferred over the open technique
Summary
15.000 patients in the Netherlands are diagnosed with end-stage renal disease (ESRD) and are dependent on renal replacement therapy (peritoneal dialysis, haemodialysis or transplantation). PD has several advantages over haemodialysis (HD): it allows patients greater freedom to perform daily activities, it requires fewer dietary restriction, and mortality is lower during the first two years of treatment [1]. We have noticed that PD catheter insertion has a high rate of technical failure using the standard open technique. Case-series report up to 35% catheter failure with the open technique. Comparative trials reported no significant difference in the risk of catheter removal, replacement or technical failure between both techniques [9,16,17,18,19], there are no well-designed randomized controlled trials comparing laparoscopic PD catheter insertion to the traditional open technique
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
