Post-implantation events of swan-neck catheters for PD

Abstract

summary The first step in PD is the implantation of a peritoneal catheter, a technique that is subject to different possible incidences. We have studied the non-infectious events or incidences (pericatheter leakage, blood tinged dialysate, catheter displacement, omental wrapping and extra-peritoneal placement) registered in our unit during a five-year period (1992–1996) after the implantation of 144 swan-neck curled catheters in 100 peritoneal dialysis patients, 49 males and 51 females. 70 catheters (48.61 %) were implanted using the blind puncture method and 74 (51.39 %) with the surgical method. All the incidence rates were compared between the two methods to analyse the possible influence of the implantation technique. 21 pericatheter leaks, 19 episodes of blood tinged dialysate, 10 displacements, 7 cases of omental wrapping and 4 extra-peritoneal placements (all of them after blind punctures carried out by young assistant doctors) were registered, with a total number of 61 incidences (0.42 per catheter). Statistically significant differences were not found either globally or for each type of event when comparing the incidence rates between the two implantation techniques, although extra-peritoneal placement was close to significant (p = 0.053). None of the incidences were severe. 25 catheters (17.4%) had to be replaced with the removal rates being similar for both techniques. In conclusion, in our experience neither technique shows a clear advantage over the other. Experienced staff members should implant PD catheters.