title: Comparison between the fixation of peritoneal dialysis catheters to the peritoneal wall and the conventional placement technique: clinical experience and follow-up of a new implant technique for peritoneal dialysis catheters.
abstract: Peritoneal dialysis (PD) catheters often become severely dislocated, which may lead to malfunction. With the aim of preventing this complication, we have developed a simple method of fixing the catheter downwards in the peritoneal cavity (fixation technique), a technique that does not require a laparoscope. Sixteen patients were implanted using the conventional placement technique and 25 patients were implanted using the fixation technique. The location of the catheter tip was classified from grade 1 (downward, normal) to 5 (dislocated). The frequency of dislocation (defined as the extended time and/or decrease in volume when draining the PD solution) was measured for both the fixation technique and conventional placement technique. There was a significant difference in grade between the fixation technique (2.72 ± 1.01) and conventional technique (3.92 ± 1.31). The time until first dislocation was significantly different between the fixation technique (59.3 ± 48.1 days) and conventional technique (8.8 ± 14.6 days). The time until any dislocation was significantly different between the fixation technique (69.2 ± 41.9 days) and conventional technique (12.9 ± 13.7 days). Complications were not significantly different between the fixation technique and conventional technique. The fixation technique appears to be simple, safe, and useful for preventing severe dislocation and for lengthening the time until dislocation in PD patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Io
authors.forename: Kunimi
authors.initials: K
authors.lastname: Maeda
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Sekiguchi
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Shimaoka
authors.forename: Seiki
authors.initials: S
authors.lastname: Aruga
authors.forename: Junichiro
authors.initials: J
authors.lastname: Nakata
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Nakamoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hotta
authors.forename: Ichiro
authors.initials: I
authors.lastname: Koyanagi
authors.forename: Masanori
authors.initials: M
authors.lastname: Inaba
authors.forename: Reo
authors.initials: R
authors.lastname: Kanda
authors.forename: Takanori
authors.initials: T
authors.lastname: Nakano
authors.forename: Keiichi
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Yuu
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Jiro
authors.initials: J
authors.lastname: Inuma
authors.forename: Kayo
authors.initials: K
authors.lastname: Kaneko
authors.forename: Chieko
authors.initials: C
authors.lastname: Hamada
authors.forename: Mitsumine
authors.initials: M
authors.lastname: Fukui
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomino
mesh_terms: 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 / Q000295:instrumentation*; D010537:Peritoneum / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies