Moncrief-Popovich technique is an advantageous method of peritoneal dialysis catheter implantation

Abstract

A safe and well-functioning peritoneal catheter is fundamental for adequate peritoneal dialysis (PD) treatment. Peritoneal catheter implantation by Moncrief-Popovich (MP) technique might add several clinical advantages besides allowing timely access implantation. The aim of this study was to investigate the rate of catheter-related complications and survival in a single-centre university hospital PD unit, according to the method of catheter implantation. Four hundred and sixty-seven consecutive Tenckhoff catheters were implanted after antibiotic prophylaxis in an operating room: surgical mini-laparotomy (ML) was used in 211 (45%), Seldinger technique (S) in 76 (16%) and mini-laparotomy with MP method in 180 (38.5%). The MP technique was significantly associated with a lower rate of early exit-site infection (ESI) (P = 0.02), lower rate of leak (P < 0.0001) and also lower rate of obstruction (P = 0.034) in spite of prolonged break-in (median 55 days, range 0-991 days). Catheter survival by MP technique was 92%, 83% and 64% at 12, 24 and 60 months, respectively, and significantly superior in comparison with the previous methods (log-rank, P = 0.032). By Cox multivariate analysis, adjusted for age, sex and diabetes, the MP technique remained independently associated with better catheter survival [hazard ratio (HR) 0.587 (0.397-0.870), P = 0.008]. Our experience documented improved PD clinical outcomes with the MP method of catheter implantation while assuring timely access management and logistic advantages.