You are here

PERİTON DİYALİZİNDE KATETER YERLEŞTİRME TEKNİĞİNİN KOMPLİKASYONLAR VE DİYALİZ ETKİNLİĞİ AÇISINDAN KARŞILAŞTIRILMASI

COMPARING CATHETER PLACEMENT TECHNIQUES BY COMPLICATIONS AND DIALYIS EFFICACY IN PERITONEAL DIALYSIS

Journal Name:

Publication Year:

Abstract (2. Language): 
Objective: Patients with end-stage renal disease (ESRD) require renal replacement treatment (RRT). Peritoneal dialysis (PD) is a modality of dialysis which involves a silicone tube inserted in the abdominal cavity, called the catheter, and with special solutions, called dialysate, administered to the abdominal cavity through the catheter. Peritoneal catheters may be introduced via surgical or percutaneous procedures. The present study aims to compare the complications and dialysis efficacy by catheter insertion methods in patients on PD being monitored in our polyclinic. Materials and methods: A total of 23 patients on PD, 11 males and 12 females, who had ESRD diagnosed for 41.4 ± 15 months, were included in this study. These patients were divided into two groups by the method of catheter insertion, e.g., via the laparoscopic surgery (group 1, n: 6) or percutaneously under local anesthesia (group 2, n: 13). Complications following the respective procedure in each group were compared and patients‟ Kt/V values were studied to determine dialysis efficacy. No significant difference was identified in dialysis efficacy (Kt/V) between the two catheter insertion methods (p>0.05). Results: There was an increased incidence of complications in the group of patients whose catheters were inserted via the surgical procedure, although the two groups were matched in terms of accompanying diseases. Conclusion: This result suggests that PD catheter insertion can be performed conveniently by a nephrology clinic team with adequate training and experience and that this is a procedure with fewer complications, provided that the procedure is performed on well-selected patients.
Abstract (Original Language): 
Amaç: Son dönem böbrek yetmezliği (SDBY) olan hastalar renal replasman tedavisine (RRT) ihtiyaç duyarlar. Periton Diyalizi (PD); karın boĢluğuna yerleĢtirilen, kateter adını verdiğimiz silikon bir tüp ve diyalizat denilen karın boĢluğuna verilen özel solüsyonlar aracılığı ile yapılan bir diyaliz yöntemidir. Periton kateterleri cerrahi veya perkütan yöntemlerle takılabilir. Biz bu çalıĢmada polikliniğimizde izlenen PD hastalarımızın periton kateteri takılma Ģekline göre komplikasyonlarını ve diyaliz etkinliğini karĢılaĢtırmayı amaçladık. Gereç ve yöntem: Bu çalıĢmada SDBY için hastalık süresi 41,4 ± 15 ay olan 11 kadın, 12 erkek toplam 23 PD hastası alındı. Hastalar cerrahi yolla laparoskopik olarak (grup 1, n: 6) ve lokal anestezi altında perkütan olarak (grup 2, n: 17) kateter takılan Ģeklinde iki gruba ayrıldı. Her iki grubun yapılan iĢlem sonrasındaki komplikasyonları karĢılaĢtırıldı ve diyaliz etkinliğini değerlendirmek için Kt/V „sine bakıldı. Bulgular: Kateter takım teknikleri arasında diyaliz etkinliği (Kt/V) açısından fark bulunmadı (p>0,05). YandaĢ hastalık açısından fark bulunmayan iki grup arasında cerrahi yolla takılan kateterlerde komplikasyon oranı daha yüksek bulunmuĢtur. Sonuç: Bu da bize hasta seçimi iyi yapıldığı taktirde, PD kateteri yerleĢtirmenin yeterli eğitim ve tecrübeye sahip olan nefroloji kliniği ekibi tarafından kolayca yapılabilecek ve daha az komplikasyona yol açacak bir iĢlem olabileceğini düĢündürmektedir.
43-45

REFERENCES

References: 

1. Aksu N, Yavascan O, Anil M, Kara OD, Erdogan H, Bal A. A tenyear single-centre experience in children on chronic peritoneal dialysis-significance of percutanous placement of peritoneal dialysis catheters. Nephrol Dial Transplant 2007; 22: 2045-2051.
2. Allon M, Soucie JM, Macon EJ. Complications with permanent peritoneal dialysis catheters: Experience with 154 percutaneously placed catheters. Nephron 1988; 48: 8-11.
3. Bullmaster JR, Miller SF, Finley RK Jr, Jones LM. Surgical aspects of the Tenckhoff peritoneal dialysis
catheter. A 7 year experience. Am J Surg 1985;149: 339-342.
4. Dalgic A, Ersoy E, Engin A. A Novel Minimal Invasive Technique for Insertion of the Peritoneal Dialysis Catheter in Patients with End Stage Renal Disease. Turk Neph Dial Transpl 2001; 10: 37-40.
5. Eklund BH. Surgical implantation of CAPD catheters: Presentation of midline incision-lateral placement method and a review of 110 procedures. Nephrol Dial Transplant 1995; 10: 386-390.
6. Gadallah MF, Mignone J, Torres C, Ramdeen G, Pervez A. The role of peritoneal dialysis catheter configuration in preventing catheter tip migration. Adv Perit Dial 2000; 16: 47–50.
7. Leblanc M, Ouimet D, Pichette V. Dialysate leaks in peritoneal dialysis. Semin Dial 2001; 14: 50-54.
8. Lund R, Jonler M. Peritoneal dialysis catheter placement-is laparoscopy an option? Int Urol Nephrol 2007; 39: 625-628.
9. Moreiras Plaza M, Cuina L, Goyanes GR, Sobrado JA, Gonzalez L. Mechanical complications in chronic peritoneal dialysis. Clin Nephrol 1999; 52: 124-130.
10. Nissenson Gentile D, Soderblow R, Soderblom RE, Oliver DF, Brax C. Morbidity and mortality of continuous ambulatory peritoneal dialysis: Regional experience and long-term prospects. Am J Kidney Dis 1986; 7: 229-234.
11. Ogunc G. Minilaparoscopic extraperitoneal tunneling with omentopexy: A new technique for CAPD catheter placement. Perit Dial Int 2005;25: 551-555.
12. Ogunc G, Tuncer M, Ogunc D, Yardimsever M, Ersoy F. Laparoscopic omental fixation technique versus open surgical placement of peritoneal dialysis catheters. Surg Endosc 2003;17: 1749-1755.
13. Ozener C, Bihorac A, Akoglu E. Technical survival of CAPD catheters: Comparison between percutaneous and conventional surgical placement techniques. Nephrol Dial Transplant 2001; 16: 1893–1899.
14. Strippoli GFM, Tong A, Johnson D. Catheter-related interventions to prevent peritonitis in peritoneal dialysis: A systematic review of randomized, controlled trials. J Am Soc Nephrol 2004; 15: 2735-2746.
15. Tiong HY, Poh J, Sunderaraj K Wu YJ, Consigliere DT: Surgical complications of tenckhoff catheters used in continuous ambulatory peritoneal dialysis. Singapore Med J 2006; 47: 707-711.
16. Tzamaloukas AH, Gibel LJ, Eisenberg B: Early and late per itoneal dialysate leaks in patients on CAPD. Adv Perit Dial 1990; 6: 64-71.
17. Veys N, Van Biesen W, Vanholder R, Lameire N: Peritoneal dialysis catheters: The beauty of simplicity or the glamour of technicality? Percutaneous vs surgical placement. Nephrol Dial Transplant 2002;17: 210-212.
18. Zaman F, Pervez A, Atray NK, Murphy S, Work J, Abreo KD: Fluoroscopy-assisted placement of peritoneal dialysis catheters by nephrologists. Semin Dial 2005;18: 247-251
19. Zappacosta AR, Perras ST, Closkey GM. Seldinger technique for Tenckhoff catheter placement. ASAIO Trans 1991; 37: 13-15.

Thank you for copying data from http://www.arastirmax.com