title: A modified open surgery technique for peritoneal dialysis catheter placement decreases catheter malfunction.
abstract: BACKGROUND
  This retrospective study was conducted to evaluate the effect of a new, modified open surgery technique on catheter-related malfunction.
  
  
  METHODS
  During the period from January 1997 to June 2009, 216 patients received initial peritoneal catheters. For the present study, patients were divided into four groups according to the catheter types and the surgery techniques: TO-S: traditional open surgery, straight Tenckhoff catheter TO-C: traditional open surgery, coiled Tenckhoff catheter TO-SN: traditional open surgery, swan-neck catheter MO-S: modified open surgery, straight Tenckhoff catheter The modified surgery was characterized by a low incision site, a short intra-abdominal catheter segment and an additional upward straight subcutaneous tunnel. All patients were followed up for 2 years or until death. Survival rates, complications caused by catheter placement, and the probability of malfunction-free catheter survival were compared between the groups.
  
  
  RESULTS
  Catheter malfunction was the most frequent mechanical complication, found in 31 patients (14.4%), who experienced 38 malfunctions. Only 2 episodes of catheter malfunction were found in the MO-S group, representing a rate significantly less than those in the TO-S and TO-C groups (both p < 0.05). Kaplan-Meier curves for malfunction-free PD catheter survival showed a significantly different malfunction-free probability for the various groups (p = 0.009). After 2 years of follow-up, 136 patients (63.0%) survived with their initial PD catheter. The initial catheter survival rate was 76.8% in the MO-S group. Kaplan-Meier curves for initial catheter survival showed that the highest survival rate was found in the MO-S group (p = 0.001).
  
  
  CONCLUSIONS
  The modified open surgery technique is a reliable method for catheter placement.
authors.affiliation: Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China.
authors.forename: Chunming
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China.
authors.forename: Linfeng
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Yan
authors.affiliation: Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China.
authors.forename: Miao
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate
keywords: Peritoneal dialysis catheter; catheter malfunction; mechanical complications; surgery