title: Modified Simple Peritoneal Wall Anchor Technique (PWAT) in Peritoneal Dialysis.
abstract: ♦ BACKGROUND: Outflow obstruction, a common complication in patients with peritoneal dialysis (PD), usually results in unnecessary catheter removal or replacement. This study describes a modified simple method of anchoring a PD catheter on the anterior peritoneal wall without using a laparoscopic system (peritoneal wall anchor technique, PWAT). ♦ METHODS: We performed a retrospective cohort study of consecutive PD catheter insertions, and compared the catheter survival rate between the traditional method and the modified simple PWAT. The traditional method was used in 54 cases and the modified simple PWAT was used in 17 cases. The primary endpoint was the occurrence of surgical catheter repair because of outflow obstruction by day 365. The secondary endpoint was the occurrence of catheter migration with obstruction requiring any interventions, including the alpha-replacement method by day 365. Catheter survival was analyzed by Kaplan-Meier survival curves. ♦ RESULTS: Migration-free catheter survival was significantly (p = 0.02) higher in the PWAT group (100%, 17/17) than in the traditional group (72.2%, 39/54). Catheter survival without surgical repair or cessation of PD was also significantly (p = 0.04) higher in the PWAT group (100%, 17/17) than in the traditional group (77.8%, 42/54). Similarly, migration-free and surgery-free catheter survival rates in cases with a straight-type catheter in the PWAT group were significantly higher than those in cases with a straight-type catheter in the traditional group. ♦ CONCLUSIONS: Our results suggest that the modified simple PWAT provides a better catheter survival rate than the traditional method by preventing catheter migration with obstruction in PD.
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Oka
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Kamimura
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hara
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hirashima
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Shumei
authors.initials: S
authors.lastname: Matsueda
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Shukuri
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Seishi
authors.initials: S
authors.lastname: Aihara
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Koresawa
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Eriguchi
authors.affiliation: Division of Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Atsumi
authors.initials: A
authors.lastname: Harada
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan tsuruya@intmed2.med.kyushu-u.ac.jp.|Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
mesh_terms: D000328:Adult; D000368:Aged; D061807:Catheter Obstruction / Q000009:adverse effects*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling; D015331:Cohort Studies; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D053441:Suture Anchors; D016896:Treatment Outcome
keywords: Catheter insertion; catheter migration; outflow obstruction; peritoneal dialysis; peritoneal wall anchor technique