Long-Term Outcomes of Single-Port Laparoscopic Placement of Peritoneal Dialysis Catheter.
BACKGROUND
Laparoscopic insertion of peritoneal dialysis (PD) catheter has become a preferred method compared to the traditional open technique for PD catheter insertion. We retrospectively report the outcome of 1-port laparoscopic placement PD catheters in our institution.


METHODS
A total of 263 patients with end-stage renal disease who underwent single-trocar laparoscopic PD catheter insertion during a recent 6-year period were reviewed. Laparoscopic technique involves introducing a PD catheter over a stiff guidewire into the abdominal cavity through a 10-mm laparoscopic port. Pertinent clinical variables, procedural complications, and follow-up outcome were analyzed.


RESULTS
There were 182 men and 81 women. The mean age was 56 years. Technical success was 95.8%. Catheter occlusion was the most common early complications (<6 months) that occurred in 4 (1.5%) patients. Late complications (> 6 months) including catheter occlusion, cuff extrusion, catheter leakage, catheter migration, infection, and hernia occurred in 5 patients (1.9%), 2 patients (0.8%), 3 patients (1.1%), 3 patients (1.1%), 6 patients (2.3%), and 4 patients (1.5), respectively. Mean follow-up time was 39 ± 18 months. Catheter survival rate at 1, 2, 3, 4, and 5 years was 96%, 94%, 90%, 85%, and 82%, respectively.


CONCLUSIONS
Laparoscopic PD catheter implantation via a single-trocar utilizing a stiff guidewire technique is feasible and safe. This method can result in low complication and high catheter survival rate.
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Alan
A
Pan
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Mun J
MJ
Poi
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Jesus
J
Matos
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Jenny S
JS
Jiang
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Elias
E
Kfoury
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Angela
A
Echeverria
Department of Cardiothoracic and Vascular Surgery, Houston Methodist Hospital, Houston, TX, USA.
Carlos F
CF
Bechara
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA plin@bcm.edu.
Peter H
PH
Lin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061807:Catheter Obstruction / Q000209:etiology; D055499:Catheter-Related Infections / Q000382:microbiology / Q000628:therapy; D002408:Catheters, Indwelling; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000628:therapy; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
dialysis access; laparoscopic; peritoneal dialysis; peritoneal dialysis catheter; single port