Laparoscopic versus Open-surgery Catheter Placement in Peritoneal Dialysis Patients: A Meta-analysis of Outcomes.

Abstract

The peritoneal dialysis catheter (PDC) can be placed either through the laparoscopic technique, percutaneous technique or surgical procedures. The utilization of these PDC placement procedures is based on successful placement and reduced risk of development of complications. The main objective of this study was to compare the complications associated with laparoscopic vs. open-surgery PDC placement procedure. Literature for this review was obtained from PubMed and Google Scholar databases. The literature search was limited to studies published in the period between 1998 and 2019. The meta-analysis was done using Stata Version 12. The results showed significant difference in catheter malfunction between the laparoscopic and open-surgery group (relative risk [RR] =0.58; 95% CI: 0.42–0.8; P = 0.031). Furthermore, there was no significant statistical difference in dialysate leakage (RR = 0.77; 95% CI: 0.51–1.17, P = 0.116) peritonitis (RR = 0.8; 95% CI: 0.6–1.06, P = 0.349) and exit-site infection (RR = 0.84; 95% CI: 0.65–1.09, P = 0.834) between the laparoscopic and open-surgery PDC placement groups. In conclusion, the laparoscopic PDC placement procedure was superior to open surgery in regards to catheter malfunction. Additionally, the choice of treatment procedure should put in consideration factors such as cost and comfortability of the patient.