MP37-19 PERITONEAL DIALYSIS CATHETER INSERTION WITH OR WITHOUT OMENTECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-19 PERITONEAL DIALYSIS CATHETER INSERTION WITH OR WITHOUT OMENTECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS Jin Kyu (Justin) Kim, Marisol Lolas, Daniel Keefe, Mandy Rickard, Priyank Yadav, Armando Lorenzo, and Michael Chua Jin Kyu (Justin) KimJin Kyu (Justin) Kim More articles by this author , Marisol LolasMarisol Lolas More articles by this author , Daniel KeefeDaniel Keefe More articles by this author , Mandy RickardMandy Rickard More articles by this author , Priyank YadavPriyank Yadav More articles by this author , Armando LorenzoArmando Lorenzo More articles by this author , and Michael ChuaMichael Chua More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peritoneal dialysis (PD) is an option for renal replacement in patients with end-stage renal disease. Once placed in the peritoneal cavity, there is a chance of malfunction, often attributed to omental wrapping. Currently, there is mixed evidence regarding the role of omentectomy in improving PD outcomes and survival. This investigation aims to perform a systematic review and meta-analysis of literature on this topic to understand whether omentectomy during PD catheter insertion confers advantages. METHODS: A systematic review was performed in accordance with the Cochrane Collaboration. The review protocol was registered on the PROSPERO database (CRD42020218950). The systematic literature search was performed in February 2021 across Medline, EMBASE, Scopus, and Cochrane Library. All records with patients who underwent PD catheter insertion with and without omentectomy were included. The identified records were screened, followed by full-text review and data-extraction. Study quality was assessed using RoBINS-I and RoB2. The effect estimates were extracted as risk ratios (RRs) and corresponding 95% confidence intervals (CI) were pooled using inverse variance method with random effect model. Reporting of the study was in compliance with PRISMA guidelines. RESULTS: A total of 510 records were identified. 331 records were screened following duplicate removal and 37 records were identified for full-text review. 15 studies were ultimately included in the meta-analysis (2 prospective, 13 retrospective). When employing omentectomy, there was decreased likelihood of failure leading to removal of PD catheter (RR 0.47 [95% CI 0.38, 0.58]) and PD catheter obstruction (RR 0.23 [95% CI 0.14, 0.39]). Whether omentectomy was employed or not, there was no difference in malposition or migration of PD catheter (RR 0.87 [95% CI 0.23, 3.29]) or peritonitis (RR 0.74 [95% CI 0.40, 1.35]). CONCLUSIONS: Pooled effect estimates from our meta-analysis suggests that omentectomy confers benefits of decreased obstruction and failure requiring removal. The majority of the studies were retrospective in design and with higher risk of bias; hence, well-designed prospective studies are needed to validate these findings. Source of Funding: None. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e653-e654 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jin Kyu (Justin) Kim More articles by this author Marisol Lolas More articles by this author Daniel Keefe More articles by this author Mandy Rickard More articles by this author Priyank Yadav More articles by this author Armando Lorenzo More articles by this author Michael Chua More articles by this author Expand All Advertisement Loading ...