title: Outcomes after peritoneal dialysis catheter placement.
abstract: BACKGROUND
  The purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease.
  
  
  METHODS
  Children with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (>30days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age<2, and weight<10kg. Univariate and multivariate analysis were performed.
  
  
  RESULTS
  One hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7±6.3years. Mean catheter life was similar in the laparoscopic and open groups (581±539days versus 574±487days, p=0.938). The late complication rate was higher for open procedures (57% versus 37%, p=0.013). Children age<2 or weight<10kg had higher re-operation rates (64% versus 42%, p=0.014 and 73% versus 40%, p=0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation.
  
  
  CONCLUSIONS
  Laparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children <2years age or <10kg remain at risk for complications regardless of technique.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Carpenter
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Fallon
authors.affiliation: Renal Service, Department of Pediatric Medicine, Texas Children's Hospital, Houston, TX.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Swartz
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Minifee
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Darrell L
authors.initials: DL
authors.lastname: Cass
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Jed G
authors.initials: JG
authors.lastname: Nuchtern
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Ashwin P
authors.initials: AP
authors.lastname: Pimpalwar
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX. Electronic address: mary.brandt@bcm.edu.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001835:Body Weight; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chronic kidney disease; Dialysis; Peritoneal