Comparison of Outcomes between Percutaneous and Surgical Placement of Peritoneal Dialysis Catheters in Uremic Patients: A Meta-Analysis

Autor:	Jing Xu, Cheng Xue, Yuqiang Zhang, Shoulian Zhou, Xuezhi Zhao, Sixiu Chen, Mengna Ruan, Yixin Qian, Linxi Huang, Bo Yang, Zhiguo Mao, Changlin Mei, Jun Wu
Rok vydání:	2021
Předmět:	medicine.medical_specialty Percutaneous Catheter insertion business.industry medicine.medical_treatment Hematology General Medicine Odds ratio End stage renal disease law.invention Surgery Peritoneal dialysis Catheter Randomized controlled trial Nephrology law Meta-analysis Medicine business
Zdroj:	Blood Purification. 51:328-344
ISSN:	1421-9735 0253-5068
Popis:	Background: The optimal technique for inserting peritoneal dialysis catheters in uremic patients remains debated. This meta-analysis aimed to summarize the current evidence evaluating the efficacy and safety of percutaneous insertion methods compared to surgical methods. Method: A literature search was performed in the PubMed, EMBASE, Cochrane, and Web of Science databases. The primary outcome was defined as catheter survival. The secondary outcomes were mechanical and infectious complications related to catheter insertion. Results: Twenty studies were finally identified, including 2 randomized controlled trials. The pooled results of catheter survival, overall mechanical complications, and infectious complications were not significant (odds ratio [OR] = 1.10, 95% confidence interval (CI) = 0.76–1.57, p = 0.62; OR = 0.73, 95% CI = 0.48–1.11, p = 0.14; and OR = 0.64, 95% CI = 0.37–1.09, p = 0.14, respectively). Comparison stratified by the blind percutaneous method versus open surgery indicated a lower overall number of mechanical complications (OR = 0.54, 95% CI = 0.31–0.93, I2 = 72%) and malposition rate (OR = 0.56, 95% CI = 0.34–0.90, I2 = 0%). The leakage rate was higher in the blind percutaneous group than in the open surgery group (OR = 2.55, 95% CI = 1.72–3.79, I2 = 0%); the guided percutaneous method achieved a similar leakage risk to the surgical methods. Conclusions: The blind percutaneous method performed better with fewer overall mechanical complications and less malposition than open surgery. The leakage risk was higher in the blind percutaneous group, while the guided percutaneous placement group showed similar outcomes to the surgical method groups. Percutaneous methods also had a lower infection risk, which needs further evidence to be confirmed.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::9a2d2706b34b350fc3de077e1e75ff38 https://doi.org/10.1159/000516145 Zobrazit plný text záznamu