title: Tenckhoff catheters post-renal transplantation: the 'pull' technique?
abstract: BACKGROUND
  Tenckhoff catheters are used widely for the provision of continuous ambulatory peritoneal dialysis. Traditionally these catheters are removed surgically under anaesthesia. We set out to introduce and monitor prospectively a technique for removal of the Tenckhoff catheter by a 'pull' technique. The intention was to avoid the discomfort, risk and cost of traditional surgery.
  
  
  METHODS
  Over a 1-year period all renal transplant patients having their Tenckhoff catheter removed by this technique were monitored prospectively. All patients were followed for a minimum 2-year period after removal. In the pull technique steady non-jerky traction is applied to the catheter. Complications such as catheter breakage and cuff related sepsis were recorded.
  
  
  RESULTS
  Sepsis related to a retained cuff occurred in only one patient early in the series. There were no other complications. The procedure was well tolerated. Use of local anaesthesia used initially, was largely phased out over the course of study and the procedure moved from the theatre to the ward.
  
  
  CONCLUSIONS
  The pull technique is safe and well tolerated. The technique has significant advantages in selected patients without a history of recent peritonitis or exit site infection, in reducing risk to the patients, the pain of abdominal wall surgery and reduced usage of costly theatre time and in-patient beds.
authors.affiliation: University Hospital of Wales, Heath Park, Cardiff, UK. isabelquiroga@hotmail.com
authors.forename: I M
authors.initials: IM
authors.lastname: Quiroga
authors.forename: R
authors.initials: R
authors.lastname: Baboo
authors.forename: R H
authors.initials: RH
authors.lastname: Lord
authors.forename: C R
authors.initials: CR
authors.lastname: Darby
mesh_terms: D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011446:Prospective Studies; D018805:Sepsis / Q000209:etiology