title: Laparoscopic findings of peritoneal dialysis catheter malfunction and management outcomes.
abstract: OBJECTIVE
  Peritoneal dialysis catheter malfunction is a common complication forcing conversion to hemodialysis. The purpose of this study was to evaluate laparoscopic findings of catheter malfunction and to establish a relationship between those findings and the outcomes of procedures performed.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  40 consecutive patients with stage 5 chronic kidney disease underwent 46 laparoscopic correction procedures for the treatment of peritoneal dialysis catheter malfunction between November 1994 and August 2004.
  
  
  METHODS
  Laparoscopic findings of catheter malfunction, procedures performed, catheter survival, and recurrent cases were evaluated.
  
  
  RESULTS
  There were 28 tip migrations in 40 patients; 16 were without adhesions and 10 were associated with omental adhesions. Reposition and adhesiolysis were the most frequent procedures performed. Malfunction recurred in 12 patients and 5 of them underwent 6 secondary laparoscopic procedures. Estimated mean catheter survival was 19.9 +/-3.32 months (%95 confidence interval 13.43 - 26.46).
  
  
  CONCLUSIONS
  The most frequent laparoscopic finding was catheter tip migration, with or without adhesions. Laparoscopic repositioning and adhesiolysis without omentectomy are simple and effective procedures that can prolong catheter survival, even in recurrent malfunctions.
authors.affiliation: Department of Surgery, Uludag University School of Medicine, Bursa, Turkey. tunyil@uludag.edu.tr
authors.forename: Tuncay
authors.initials: T
authors.lastname: Yilmazlar
authors.forename: Turkay
authors.initials: T
authors.lastname: Kirdak
authors.forename: Serpil
authors.initials: S
authors.lastname: Bilgin
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yavuz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yurtkuran
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects; D004868:Equipment Failure; D006801:Humans; D010535:Laparoscopy; D009852:Omentum; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D010532:Peritoneal Diseases / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis; D000267:Tissue Adhesions / Q000209:etiology; D016896:Treatment Outcome