title: Laparoscopic versus open peritoneal dialysis catheter insertion, the LOCI-trial: a study protocol.
abstract: BACKGROUND
  Peritoneal dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemodialysis. Key to successful PD is the presence of a well-functioning dialysis catheter. Several complications, such as in- and outflow obstruction, peritonitis, exit-site infections, leakage and migration, can lead to catheter removal and loss of peritoneal access. Currently, different surgical techniques are in practice for PD-catheter placement. The type of insertion technique used may greatly influence the occurrence of complications. In the literature, up to 35% catheter failure has been described when using the open technique and only 13% for the laparoscopic technique. However, a well-designed randomized controlled trial is lacking.
  
  
  METHODS
  The LOCI-trial is a multi-center randomized controlled, single-blind trial (pilot). The study compares the laparoscopic with the open technique for PD catheter insertion. The primary objective is to determine the optimum placement technique in order to minimize the incidence of catheter malfunction at 6 weeks postoperatively. Secondary objectives are to determine the best approach to optimize catheter function and to study the quality of life at 6 months postoperatively comparing the two operative techniques.
  
  
  CONCLUSIONS
  This study will generate evidence on any benefits of laparoscopic versus open PD catheter insertion.
  
  
  BACKGROUND
  Dutch Trial Register NTR2878.
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. s.hagen@erasmusmc.nl
authors.forename: Sander M
authors.initials: SM
authors.lastname: Hagen
authors.forename: Arjan M
authors.initials: AM
authors.lastname: van Alphen
authors.forename: Jan N M
authors.initials: JN
authors.lastname: Ijzermans
authors.forename: Frank J M F
authors.initials: FJ
authors.lastname: Dor
mesh_terms: D000328:Adult; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome