Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: Clinical results in 78 patients 1,2

N. Stanley Nahman, Donald F. Middendorf, William H. Bay, Renee McElligott, Sherri Powell, Judith Anderson

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

The placement of percutaneous peritoneal dialysis catheters under direct peritoneoscopic visualization is a relatively new technique for establishing peritoneal dialysis access. In this study, in which a modification of the Seldinger technique was used to facilitate the placement of the peritoneoscope, the experience with 82 consecutive catheterization procedures in 78 patients is reported. In 2 (2.4%) of 82 catheterization procedures, we were unable to enter the peritoneal cavity but experienced no other complications unique to the percutaneous approach. Of the 80 successful catheterization procedures, 76 represented first-time catheter placement and constituted a population subjected to life-table analysis examining catheter survival rates, the time to first cutaneous exit site or s.c. tunnel infection, and the time to first episode of peritonitis. After a follow-up period of 50.1 patient yr, 11 catheters were lost because of catheter dysfunction. Other clinical complications included peritoneal fluid leaks at the cutaneous exit site in 11 instances (0.22/patient yr), cutaneous exit site infection in 7 instances (0.14/ patient yr), s.c. tunnel infection in 2 instances (0.04/ patient yr), and 34 episodes of peritonitis (0.68/patient yr). The results of this study demonstrate that the suggested modification of the percutaneous placement of peritoneal dialysis catheters, under peritoneoscopic visualization, is a viable method for establishing peritoneal access.

Original languageEnglish (US)
Pages (from-to)103-107
Number of pages5
JournalJournal of the American Society of Nephrology
Volume3
Issue number1
StatePublished - Jul 1 1992
Externally publishedYes

Keywords

  • Continuous ambulatory peritoneal dialysis
  • Peritoneal cannulation
  • Seldinger technique
  • Tenckhoff catheter

ASJC Scopus subject areas

  • Nephrology

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