Continuous ambulatory peritoneal dialysis catheter placement: Is omentectomy necessary?
BACKGROUND
There are different methods of continuous ambulatory peritoneal dialysis (CAPD) catheter placement. Open surgical technique is a widely followed method. The complication rate following catheter placement varies and catheter blockage due to omental plugging is one of the main reasons.


OBJECTIVE
To analyze the need for routine omentectomy during CAPD catheter placement.


METHODS
This was a retrospective analysis of 58 CAPD catheter placements performed between July 2002 and June 2007. Tenckhoff double cuffed catheter was used in all. The postoperative complications were analyzed.


RESULTS
There were 44 males and 14 females. The mean age was 51 years ranging from 15 to 76 years. Of these, 40 (69%) patients underwent omentectomy (group A) and 18 (31%) did not (group B). Laparoscopic and open techniques were performed in 5 and 53 patients, respectively. Omentectomy was not performed in 13 patients with open technique and all the five in the laparoscopic group. One patient in group A developed hemoperitoneum which was treated conservatively. None from group A developed catheter blockage, whereas five (27.8%) from group B developed catheter blockage postoperatively. The median time interval between the primary procedure and development of catheter blockage was 45 days (ranged from 14 to 150 days).


CONCLUSIONS
Omentectomy during CAPD catheter placement prevents catheter blockage and secondary interventions.
Kavalakkat
Joseph P
JP
Department of Urology, CMC, Vellore, Tamil Nadu, India.
Kumar
Santosh
S
Aswathaman
Karthikeyan
K
Kekre
Nitin S
NS