Absence of leakage by insertion of peritoneal dialysis catheter through the rectus muscle.
To reduce leakage of peritoneal dialysis fluid, insertion of a 2-cuff Tenckhoff catheter (TeC) was performed under local anaesthesia by a lateral approach on 30 occasions in 26 patients. Incision was 3 cm laterally of the linea alba. The inner cuff of the TeC was fixed by a purse-string suture of the peritoneal membrane on the abdominal side of the cuff and another purse-string suture, of the inner fascial blade, around the distal end of the cuff. A third purse-string suture was placed around the TeC at the exit through the outer fascial blade. A subcutaneous tunnel completed the insertion. In all patients, dialysis was started immediately after TeC insertion. The median treatment time was 6.5 months (range 3 days-15 months). No leakage developed in any patient and no hernia was created from this approach. Peritonitis was treated on 8 occasions over a period of 163 months. We conclude that the technique is simple, enables immediate start of dialysis with low risk for leakage.
Stegmayr
B
B
Department of Internal Medicine, University Hospital, Umeå, Sweden.
Hedberg
B
B
Sandzen
B
B
Wikdahl
A M
AM
D000009:Abdominal Muscles; D002404:Catheterization / Q000379:methods; D002408:Catheters, Indwelling; D015314:Dialysis Solutions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013536:Suture Techniques; D013997:Time Factors
D015314:Dialysis Solutions