Peritoneal dialysis access

UNLABELLED: ♦ OBJECTIVE: Peritoneal dialysis (PD)-related infection is a common cause of catheter loss and the main reason for PD drop-out. Exit-site infection (ESI) is a pathway to developing tunnel infection and peritonitis, hence rigorous exit-site care has always been emphasized in PD therapy. The aim of this study was to evaluate the effect of exit-site dressing vs non-dressing on the rate of PD-related infection. ♦ METHODS: A prospective randomized controlled study was conducted in prevalent PD patients at the Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia, from April 2011 until April 2013...

UNLABELLED: ♦ BACKGROUND: A functioning catheter is vital to the success of peritoneal dialysis (PD). Catheter complications related to the insertion procedure remain a major hindrance to PD utilization. Most catheters are placed by surgeons. Suboptimal catheter outcomes appear to be related to inadequate training and experience during surgical residency and the absence of educational opportunities to remedy this deficit once the surgeon is in practice. ♦ OBJECTIVE: The aim of this report is to describe a 1-day comprehensive surgeon training program in PD access surgery and to convey the results of the first 7 courses...

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PURPOSE: Several small studies have suggested that the percutaneous method of peritoneal dialysis (PD) catheter insertion is effective and has a lower complication rate than surgical techniques (open, laparoscopic or peritoneoscopic), although no randomized, controlled study has compared these methods. Our objective was to compare percutaneous PD catheter insertion vs surgical placement in terms of 1-year catheter survival, catheter dysfunction, fluid leak and incidence of peritonitis...

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PURPOSE: The conventional trocar and cannula method in peritoneal dialysis (PD) catheter insertion has its limitation in clinical setting. The aim of this study was to compare a modified method for percutaneous PD catheter insertion with the conventional method, and demonstrate advantages of the modified method. MATERIALS AND METHODS: Patients at a single center who had percutaneous PD catheters inserted by nephrologists from January 2006 until September 2012, using either a modified method (group M) or the conventional trocar and cannula method (group C), were retrospectively analyzed, in terms of baseline characteristics, complications experienced up to 3 months after the procedure, and the suitability of the procedure for patients...

Various methods of peritoneal dialysis (PD) catheter insertion are available. The purpose of this study was to evaluate a percutaneous insertion technique using ultrasound (US) and fluoroscopy performed under conscious sedation and as day case procedure. Data of 87 percutaneous inserted dialysis catheters were prospectively collected, including patients' age, gender, body mass index, history of previous abdominal surgery and cause of end stage renal failure. Length of hospital stay, early complications and time to first use were also recorded...

BACKGROUND: Laparoscopy revolutionized many General Surgery procedures by decreasing hospital stay, minimizing recovery time, and reducing wound infection rates. This study evaluates the potential benefits of laparoscopic approach to peritoneal dialysis catheter (PDC) placement. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for laparoscopic and open PDC placement. We evaluated patient demographics, comorbidities, operative time, length of stay (LOS), and postoperative outcomes...

Peritoneal dialysis (PD) is an effective treatment for end-stage renal disease. There are several techniques of percutaneous PD catheter placement including trocar or Seldinger techniques. Placement can be performed with fluoroscopy and/or sonography or as a blind percutaneous procedure. Historically, percutaneous PD catheters have been placed in patients even if they had prior abdominal surgeries. The outcomes of percutaneous PD catheter placement in patients with complex abdomen (patients with two or more abdominal surgeries or known adhesions) are unknown...

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In peritoneal dialysis (PD), a well-functioning catheter is of great importance, because a dysfunctional catheter may be associated with incidence of peritonitis, efficiency of dialysis, and to the overall quality of treatment, representing one of the main barriers to optimal use of PD. When considering the relationship between PD catheter type and outcomes, we should keep in mind the different types of available PD catheters, those that are most commonly used in clinical practice, and the available head-to-head comparisons in the literature...

BACKGROUND: Peritoneal dialysis catheter (PDC) dysfunction can often be treated fluoroscopically by manipulation with wire, balloon or stiff stylet, saving surgical intervention for refractory cases. We describe an enhanced percutaneous approach to PDC salvage that can lead to a more definitive intervention and salvage for cases refractory to fluoroscopic manipulation. METHODS: In five cases of PD catheter malfunction, the deep cuff was dissected free after a 0...

INTRODUCTION: The main objective of this study was to evaluate the feasibility of a laparotomy peritoneal dialysis insertion, under locoregional anesthesia, by transversus abdominis plane block anesthesia. METHODS: This was a retrospective study of the peritoneal dialysis catheter insertion under transversus abdominis plane block anesthesia in our center between the September 1, 2011 and July 31, 2013. The transversus abdominis plane block procedure was used as an alternative to general anesthesia...

BACKGROUND: Peritoneal dialysis (PD) catheter placement is usually performed using general or local anesthesia. We present our PD catheter placement experience using an ultrasound-guided transversus abdominis plane (TAP) block, which is a regional anesthesia technique. METHODS: In this study, we analyzed 33 patients from our center with ESRD who underwent PD catheter placement using a TAP block between June 2011 and April 2014. RESULTS: The TAP block was successful for 29/33 (87...

INTRODUCTION: Automated peritoneal dialysis (APD) normally takes place overnight. Maintaining a stable PD catheter position, independent of body position, omental wrapping or catheter displacement secondary to bowel movements is essential in maintaining effective catheter function. METHODS: We developed a new procedure of catheter placement through combining and adapting several previously described operative techniques including laparoscopic placement of a curled double cuff Tenckhoff catheter with subcutaneous tunneling superior to the rectus sheet, an oblique course through the abdominal wall, deep entry into the pelvic peritoneum and directed placement of the curled tip within the pouch of Douglas...

INTRODUCTION: The optimal method for placement of peritoneal dialysis catheters (PDC) is unclear. The objective of this study was to compare the outcomes of laparoscopic and open surgical placement of PDC. MATERIALS AND METHODS: Patients who underwent laparoscopic (LPD) and open (OPD) surgical placement of PDC between 2007 and 2011 were identified from the American College of Surgeons National Surgical Quality Initiative Project (NSQIP) dataset using current procedural terminology (CPT) and international classification of diseases 9th revision (ICD-9) codes...

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