title: Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years.
abstract: BACKGROUND
  The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared.
  
  
  METHODS
  We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014.
  
  
  RESULTS
  Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 vs n = 25) (P <0.01). Patients with peritonitis were younger than those who had no attack of peritonitis (10.95 ± 0.8 years vs 13.4 ± 0.85 years). According to the development of complications, significant difference has not been found between the open (n = 9) and laparoscopic (n = 3) approaches except the peritonitis. Catheter survival rate for the first year was 95%, and for five years was 87.5%. There was no difference between open and laparoscopic group according to catheter survival rate. The mean kt/V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V.
  
  
  CONCLUSIONS
  Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method.
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Ünal
authors.initials: Ü
authors.lastname: Bıçakcı
authors.affiliation: Department of Pediatric Nephrology, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Gürkan
authors.initials: G
authors.lastname: Genç
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Tander
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Mithat
authors.initials: M
authors.lastname: Günaydın
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Demirel
authors.affiliation: Department of Pediatric Nephrology, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Özkaya
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Rıza
authors.initials: R
authors.lastname: Rızalar
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Arıtürk
authors.affiliation: Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey.
authors.forename: Ferit
authors.initials: F
authors.lastname: Bernay
keywords: Chronic Peritoneal diaysis; complication; open placement; peritonitis; single-port laparoscopic placement