Peritoneal dialysis catheter placement, outcomes and complications
| Autor: | Brad A. Feltis, Bradley J. Segura, Daniel A. Saltzman, Robert D. Acton, Melanie B. LaPlant, Donavon J. Hess |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Hernia Adolescent medicine.medical_treatment 030232 urology & nephrology Peritoneal dialysis 03 medical and health sciences Young Adult 0302 clinical medicine Catheters Indwelling Pediatric surgery Medicine Humans Risk factor Child Survival rate Salvage Therapy business.industry Infant Newborn Infant General Medicine Surgery Omentectomy Catheter Exact test 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Female Laparoscopy business Complication Omentum Peritoneal Dialysis |
| Zdroj: | Pediatric surgery international. 34(11) |
| ISSN: | 1437-9813 |
| Popis: | Peritoneal dialysis (PD) is a commonly used method for renal support in pediatric patients and can be associated with the risk of post-surgical complications. We evaluated method of placement of PD catheters with regard to post-surgical complications. PD catheters placed at two institutions between 2005 and 2017 were reviewed. Complication rates were evaluated based on method of placement, delayed usage, omentectomy, and patient age using Fisher’s exact test, two-sided, with significance set at 0.05. Factors influencing complication were evaluated with multivariate logistic regression and Kaplan–Meier survival analysis. There were 130 patients with 157 catheters placed, ranging in age from 1 day to 23 years. There was no significant difference in complication rate by method of placement or delayed usage. Infants were significantly more likely to experience leakage (21% vs 8%, p 0.036) and hernias (15% vs 5%, p 0.030). Patients that underwent an omentectomy were less likely to require a catheter replacement (7% vs 27%, p 0.004), and the catheters had a significantly higher survival rate (p 0.009). We found that laparoscopic intervention resulted in catheter salvage. Lateral exit sites may be a risk factor for catheter migration in some patients. Omentectomy is associated with longer PD catheter survival. Laparoscopic salvage of dysfunctional catheters may be a valuable adjunct in management. |
| Databáze: | OpenAIRE |
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