title: Percutaneous and surgical insertion of peritoneal catheter in patients starting in chronic dialysis therapy: a comparative study.
abstract: Percutaneous peritoneal catheter insertion can be performed by trained nephrologists. The objective of this study was to compare the outcome of peritoneal dialysis (PD) catheters percutaneous inserted with the traditional surgical technique. One hundred twenty-one PD catheters were placed in 121 stage-5 Chronic kidney disease patients using three techniques: percutaneous insertion (Group P, n = 53), percutaneous insertion guided by radioscopy (Group R, n = 26), and surgical insertion (Group S, n = 42). The mean age of the whole cohort was 57 ± 16 years and 54% were male. Patients and catheter outcomes were followed up prospectively for 19 months. Gender, age, body mass index, previous abdominal surgeries, and the prevalence of diabetes mellitus were not significantly different among the groups as well as the incidence of bleeding and the presence of catheter dysfunction. In addition, the incidence of exit-site infections and peritonitis was not significantly different among the groups. Finally, the survival catheter rate was not significantly different by the end of the follow-up of 19 months (70% in P group, 85% in R, and 70% in S group (log rank = 0.88, p = 0.95). The outcome of percutaneous implanted catheters, which were inserted by a trained nephrologist, did not demonstrate to be inferior as compared with the traditional surgical approach.
authors.affiliation: Centro de Nefrologia Intervencionista da Fundação Pró-Renal de Curitiba, Curitiba, Brazil; Departamento de Clinica Médica, Universidade Federal do Paraná, Paraná, Brazil.
authors.forename: Domingos Candiota
authors.initials: DC
authors.lastname: Chula
authors.forename: Rodrigo Peixoto
authors.initials: RP
authors.lastname: Campos
authors.forename: Márcia Tokunaga
authors.initials: MT
authors.lastname: de Alcântara
authors.forename: Miguel Carlos
authors.initials: MC
authors.lastname: Riella
authors.forename: Marcelo Mazza
authors.initials: MM
authors.lastname: do Nascimento
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002404:Catheterization / Q000295:instrumentation*; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000601:surgery*; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome