title: Merit of the cuff-shaving procedure in children with chronic infection.
abstract: Catheter replacement and cuff-shaving are per-formed as a surgical treatment against tunnel infection(TI) in patients on chronic peritoneal dialysis. The efficacy of catheter replacement is well established, but that of cuff-shaving is not. For the purpose of evaluating the efficacy of cuff-shaving, we compared the time interval between each procedure and subsequent TI. In order to perform this comparison, we reviewed data from 32 cuff-shaving procedures and 29 catheter replacement procedures at Tokyo Metropolitan Kiyose Children's Hospital in the period from 1 March 1991 to 1 May 2001, retrospectively. There was no significant difference in the time interval between each procedure and subsequent TI(P=0.284). The incidence of recurrence was no more than 12.5% for the cuff-shaving procedures. The incidence of peritonitis due to post-surgery TI with the cuff-shaving procedures was 9.3% and 6.8% with the replacement procedure (P=0.725). There was no significant variation in time interval to post-cuff-shaving TI according to the reason for the cuff-shaving procedure. In conclusion,cuff-shaving may be worth considering for TI in adequately selected patients.
authors.affiliation: Department of Pediatrics, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan. ayoshino@dokkyomed.ac.jp
authors.forename: Atsunori
authors.initials: A
authors.lastname: Yoshino
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ikeda
authors.forename: Satoko
authors.initials: S
authors.lastname: Tsuchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hataya
authors.forename: Satoru
authors.initials: S
authors.lastname: Sakazume
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Shishido
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakai
mesh_terms: D000293:Adolescent; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D010538:Peritonitis / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome