title: Peritoneal catheter fixation to the abdominal wall in surgical catheter implantation to prevent malfunction.
abstract: BACKGROUND
  Catheter failure, especially catheter displacement and obstruction remain the major barriers for peritoneal dialysis. We have developed a new surgery technique of catheter fixation on the lower abdominal wall in the catheter planting to avert the catheter mechanical complications.
  
  
  METHODS
  A retrospective study was performed on 93 patients; among them, 52 patients underwent the traditional method of surgery for catheter insertion and 41 patients received additional catheter fixation. Comparisons of complications including infection, leak, infusion pains, catheter displacement, and obstruction occurred during a follow-up period of 6 months, were made between the fixed and non-fixed groups.
  
  
  RESULTS
  Catheter fixation cost more time than the conventional operating procedure (94.2 ± 14.6 min vs. 83 ± 13.3 min, p = 0.043). Complications of infection, leak, and infusion pain that occurred in the fixed and unfixed groups are comparable. Catheter fixation reduced the complications of catheter displacement or obstruction to 0 episode in the fixed group, whereas those complications were encountered by 7 patients in the unfixed group (0/41 vs. 7/52, p = 0.022). All these 7 patients received re-exploration and catheter replacement with further catheter fixation. In the following time until now (ranging from 3 to 16 months), no catheter dysfunction was observed.
  
  
  CONCLUSIONS
  These results suggest that catheter fixation is effective in preventing catheter displacement and obstruction in peritoneal dialysis.
authors.affiliation: Renal Department, Renmin Hospital of Wuhan University, Wuhan, China.
authors.forename: Huiming
authors.initials: H
authors.lastname: Wang
authors.forename: Houjun
authors.initials: H
authors.lastname: Jia
authors.forename: Xifeng
authors.initials: X
authors.lastname: Lv
authors.forename: Guohua
authors.initials: G
authors.lastname: Ding
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D061807:Catheter Obstruction / Q000706:statistics & numerical data; D055499:Catheter-Related Infections / Q000503:physiopathology*; D002404:Catheterization; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D010529:Peritoneal Cavity / Q000601:surgery; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation*; D011183:Postoperative Complications; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies